Ileal atresia secondary to antenatal strangulation of. The diverticulum was resected and hernia was repared wihtout complications. A littre hernia occurs in less than 1% of patients with a md. Surgical resection is recommended for this type of hernia due to possible vascular complications, intestinal obstruction and herniation. He was the first to give a description of a hernial protrusion of an intestinal diverticulum. Meckel diverticulum as the sole component of the hernia sac.
Symptoms of a littre s hernia are similar to symptoms of a strangulated or incarcerated hernia. It is distinct from amyands hernia, in which the appendix is within an inguinal hernia sac. Volume 69, issue 6, novemberdecember 2017, pages 495497. Scribd is the worlds largest social reading and publishing site. A littres hernia is a complication of meckels diverticulum and it is a result of its protrusion through a herniary orifice. Littre s hernia 11% is an unusual complication of a meckel diverticulum. The herniation of a meckels diverticulum was first described by the french surgeon alexis littre in 1700,2 and have less than 50 cases described in the literature over the past 300 years. Since then the hernia sacs containing only meckels diverticula are termed as littre s hernia. This is a hernia through the linea semilunaris at the lateral border of the rectus sheath. Histopathological examination showed herniation of the meckel diverticulum littre hernia. Littres hernia, an incarcerated ventral incisional hernia. Its a rare entity and its diagnosis is often incidental during routine hernia repair surgery.
Symptoms range from abdominal cramping, fever, nausea, and frequent vomiting to swelling of the groin hernia, intense pain, and hardening of the hernia bulge. Modified tensionfree mesh repair used in rare case of littre s hernia. In 1719 alexis littre described a hernia bearing his name. Links to pubmed are also available for selected references.
Littres hernia is a rare finding consisting of a meckels diverticulum inside of a hernia sac. Littre s hernia lh is a condition defined by the presence of a meckel diverticulum md inside a. She underwent successful operative management and was discharged from hospital on the 10th postoperative day. Onuigbo wib, medical foundation and clinic, 8 nsukka lane, enugu 400001, nigeria, email. Review littres hernia the american journal of surgery. Ileal atresia secondary to antenatal strangulation of littre. The diverticulum was resected with a 12 cm free margin on both sides and the intestine was anastomosed endtoend. An ulcerated diverticulum embedded in the umbilical hernia littre hernia was dissected free from the hernial sac. Get a printable copy pdf file of the complete article 720k. Critical to the repair of richters hernia is an adequate evaluation of the intestine for viability. The definition of littres hernia is based upon the protrusion of a md through a potential abdominal opening accompanied in some cases by incarceration, inflammation, or necrosis. An inguinal hernia appears as a bulge on one or both sides of the groin. The objective of this study is the evaluation of the current evidence on littre s hernias regarding their clinical presentation and optimal treatment approach. Inguinal hernia is the most common condition in both male and female subjects.
Since then the presence of meckei s diverticu ium in a hernia sac anywhere is aiso caiied littre s hernia. Littre hernia lh is the protrusion of md through a potential abdominal opening. Any hernia containing meckels diverticulum is classified as a littre hernia. Hernia can be classified in several different ways but the most common categories are described below. A large incarcerated meckels diverticulum in an inguinal hernia. A hernia that contains a meckels diverticulum in the sac.
Get a printable copy pdf file of the complete article 720k, or click on a page image below to browse page by page. A small exomphalos minor at the base of the umbilical cord can be missed even in the postnatal period. Sep 15, 2012 a 4 cm transverse incision above the umbilicus allowed repair of the hernia as well as small bowel resection because the diverticulum was located at the umbilical hernia. Full text is available as a scanned copy of the original print version. In the year 1700, the french surgeon alexis littre was the first to describe cases of incarcerated femoral hernias containing a small bowel. Littres hernia definition of littres hernia by medical. The objective of this study is the evaluation of the current evidence on littres hernias regarding their clinical presentation and optimal treatment approach. Littre hernia definition of littre hernia by medical dictionary. Its incidence is yet unknown, but is reported that 1% of patients having a meckel diverticulum will develop a littre hernia. This is a report of the first case, to my knowledge, of a richter hernia occurring in a sacral foramen. Littre hernias are commonest in the inguinal region and may cause bowel obstruction secondary to strangulation or incarceration of the diverticulum within the hernial sac.
Strangulation of a meckels diverticulum in a femoral hernia littre s. Alexis littre 17 july 1654 3 february 1726 was a french physician and anatomist born in cordes currently cordestolosannes in the department of tarnetgaronne. A 60yearold woman had gradual onset of postsacral pain and swelling. This type of hernia is called inguinal because fat or part of the intestine slides through a weak area at the inguinal ring, the opening to the inguinal canal. An inguinal hernia occurs in the grointhe area between the abdomen and thigh. Amyands hernia is characterized by the presence of the cecal appendix, swollen or not, inside the inguinal hernia sac. A hernia pode ser classificada em diversas maneiras diferentes mas as categorias as mais comuns sao descritas abaixo. If the meckels diverticulum a congenital pouch formation on the small intestine pushes into a hernia sac, the hernia is called a littre s hernia. It is a rare finding at any age, and its true incidence is unknown. Any hernia containing the meckel diverticulum is termed a littre hernia. Littre hernias are usually presented as inguinal, femoral and umbilical hernias 5. Littre hernia is a hernia containing a meckel diverticulum, and is also known as a persistent omphalomesenteric duct hernia.
Inguinal hernia this is the most common form of hernia and makes up 75% of all abdominal. A littre hernia is a rare complication of meckels diverticulum and it is a result of its protrusion through a herniary orifice. The diagnosis of an incarcerated littre hernia on computed. Simultaneous presentation of a right littre s hernia and a. The article discusses the history and the incidence of this rare form of hernia. There are few cases published in the literature and its frequency is not well described. Pdf meckel diverticulum md is the most common congenital anomaly of the. It is most frequently encountered in the inguinal region. A rare case of an incarcerated meckels diverticulum. A littre s hernia is a rare type of hernia that is caused by a meckels diverticulum pushing through an abdominal wall opening and into an existing hernia sac. The area was drained and small intestinal contents found. Laparotomy showed that a richter hernia had occurred in the third.
Appendicitis and meckels diverticulum in a femoral hernia. Littre hernias typically occur in the inguinal region, and they may cause bowel obstruction secondary to strangulation or incarceration of the diverticulum within the. Indirect inguinal hernia an indirect inguinal hernia occurs when any intraabdominal structure protrudes through the deep inguinal ring entering the inguinal canal. The most common site of littres hernia is the inguinal canal, usually on the right. Littres hernia is an extremely rare surgical event. Littre hernia a technetium99m pertechnetate scintigraphy. Littre s hernia was originally defined as the presence of a meckels diverticulum in any hernia sac by rieke in 1841.
A hernia containing meckels diverticulum is called a littre s hernia. Modified tensionfree mesh repair used in rare case of. The definition of littre s hernia is based upon the protrusion of a md through a potential abdominal opening accompanied in some cases by incarceration, inflammation, or necrosis. Jul 06, 2018 70is yo female complaining of right sided groin pain and bloody stools. Intestinal obstruction due to incarcerated meckels. The authors report one case of littres hernia in a 42 yearold male who had the diagnosis accomplished in the intraoperative. Littre hernia is the protrusion of a meckel diverticulum through a potential abdominal opening.
A littre s hernia is an abdominal wall hernia that involves the meckels diverticulum, which is a congenital pouch formation on the small intestine that contains tissue leftover during the formation of the digestive tract and its organs. The most common site of littre s hernia is the inguinal canal, usually on the right. A 4 cm transverse incision above the umbilicus allowed repair of the hernia as well as small bowel resection because the diverticulum was located at the umbilical hernia. In recent years, reports of littre hernia are usuaiiy made on cases of a meckeis diverticuium in a femora1 hernia 2, ahhough correctly a meckeis diverticuium in any other hernia1 orifice wouid. This hernia varied from the known forms of hernias in its clinical course and in the postmortem examination results performed by littre himself. The diverticulum was resected with a 12 cm free margin. Pubmed and cochrane bibliographical databases were searched. The processus vaginalis must be patent for this type of hernia to occur. Abstract intestinal obstruction due to incarcerated meckels. The triad of exomphalos minor, meckels diverticulum and terminal ileal atresia secondary to antenatal strangulation of littre s hernia is very rare to find in the same patient. The usual sites of these socalled littre hernias are inguinal 50%, umbilical 20%, and femoral 20%. A hernia containing meckels diverticulum is called a littres hernia. Littre s hernia is the presence of a meckel diverticulum within an orifice in the abdominal wall.
Meckel diverticulum is the commonest congenital anomaly of the gastrointestinal tract. Clinically, it is indistinguishable from a hernia involving small bowel. Surgical findings included hernial sac contents with loop of ileum with signs of ischemia and a meckels diverticulum. Our patient has been operated as incarcerated inguinal hernia and littre hernia diagnosed at operation. In recent years, reports of littre hernia are usually made on cases of a meckels diverticu lum in a femoral hernia 2, although correctly a meckels diverticulum in any other hernial. It is a rare condition and represents 1% of all the inguinal hernia pathology. Meckels diverticulum is the most common congenital anomaly of the gastrointestinal tract,1 but the occurrence of a littres hernia is an extremely rare condition. Simultaneous presentation of a right littres hernia and a. The antimesenteric border of the intestine must protrude into the hernia sac the most common location is at the site of a femoral hernia. It is characterized by the presence of meckels diverticulum in the hernial sack. An indirect inguinal hernia is a congenital lesion. Littres hernia lh is a condition defined by the presence of a meckel diverticulum md inside a hernial sac. Although littre s original report related to femoral hernias, 50% of the meckels diverticula are in inguinal hernias, 20% in femoral, 20% in umbilical and remaining 10% in other miscellaneous hernias 6, 7, 8. Meckels diverticulum is the most common congenital anomaly of the gastrointestinal tract.