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Littré’s hernia
  1. Jose Pinto,
  2. Charlène Marques Viana,
  3. Ana Pereira and
  4. Joaquim Falcão
  1. General Surgery, Hospital de Braga, Braga, Portugal
  1. Correspondence to Dr Jose Pinto, josepedropinto87{at}gmail.com

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Description

A 67-year-old man with a history of bilateral inguinal hernioplasty presented to the emergency department with abdominal pain for 2 days with no obstructive symptoms. Physical examination revealed a right inguinal swelling. Ultrasography findings reported a small incarcerated hernia and he underwent a corrective surgery by anterior transverse para-inguinal approach. Instead of a recurrent inguinal hernia, we found a femoral incarcerated hernia—rare in male patients. After opening the hernial sac, there was a Littré femoral incarcerated hernia (figure 1). We performed a pre-peritoneal hernia reduction, showing a Meckel’s diverticulum (figure 2). Diverticulectomy and pre-peritoneal hernioplasty went with no perioperative complications until discharge.

Figure 1

Littré femoral incarcerated hernia after opening the hernial sac.

Figure 2

Meckel’s diverticulum, after pre-peritoneal hernia reduction.

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract,1 but the occurrence of a Littré’s hernia is an extremely rare condition. The herniation of a Meckel’s diverticulum was first described by the French Surgeon Aléxis Littré in 1700,2 and have less than 50 cases described in the literature over the past 300 years. The anatomical sites of a Littre hernia can vary, but according to the last biggest systematic review, most cases concerned incarcerated hernias: 39.6% were femoral and 34% inguinal.3

Learning points

  • Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract.

  • The herniation of a Meckel’s diverticulum—the so-called Littre hernia—was first described by the French Surgeon Aléxis Littré in 1700 and is extremely rare.

  • Anatomical sites of a Littre hernia can vary and groin hernias are the most reported.

References

Footnotes

  • Contributors JP: Planning, conduct, reporting, conception and design, acquisition of data or analysis and interpretation of data. AP: Design, acquisition of data or analysis and interpretation of data. CMV: Reporting, conception and design. JF: Planning, conduct.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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