Incarcerated right inguinal Littre’s hernia in a 30-year-old male: case report from a low-resource setting
Hashim Gibreel Teeso, Abdilkaream Mohamed, Tagwa Badawe, Eltahir Ahmed EltahirIntroduction and importance:
Meckel’s diverticulum is defined as a true diverticulum arising from the distal ileum and is the most common congenital anomaly of the small bowel, affecting approximately 2% of the population. The presence of Meckel’s diverticulum within a hernial sac, especially in the inguinal canal, is uncommon and is known as Littre’s hernia.
Clinical presentation:
A 30-year-old male with an incarcerated Littre’s hernia in the right inguinal region was successfully treated with segmental ileal resection and primary anastomosis, followed by hernial repair.
Clinical discussion:
Meckel’s diverticulum typically presents in young men with symptoms arising from ectopic gastric mucosa, where acid-related ulceration leads to complications such as painless rectal bleeding, intestinal obstruction, inflammation, and intussusception. In adults, bleeding and obstruction remain the most common manifestations, often complicating timely diagnosis. While advanced imaging modalities can aid detection in well-resourced settings, in under-resourced areas, clinical assessment remains the cornerstone of diagnosis, underscoring the importance of careful history-taking and physical examination in guiding management decisions.
Conclusion:
Littre’s hernia is a rare type of hernia in which the sac contains a Meckel’s diverticulum. The diagnosis can be challenging. In low-resource areas, diagnosis relies on clinical examination and the surgeon’s skill, as access to advanced diagnostic tools is limited.