English

Abstract

Littre's Hernia is an abnormal protrusion of Meckel's Diverticulum through an abdominal opening. Alexis Littre first described the condition in relation to a femoral hernia in 1770 (1). It is a very rare condition and very few cases are reported till date. Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. It is a true diverticulum found in the anti-mesentric border. It is the remnant of the persistent intestinal part of the vitello-intestinal or omphalo-enteric duct and comprises of all intestinal layers (2, 3, 4). It is found in 2% of total population, 2 feet from ileo-caecal junction and 2 inches in length, 2 types of common ectopic tissue (gastric and pancreatic). Meckel's diverticulum may be accompanied in the sac by the ileal loop to which it is attached; rarely, it may undergo incarceration or strangulation, necrosis, and perforation. In children, it is mostly found in umbilical hernias in which case it is more prone to adhere to the sac. Intestinal obstruction may occur due to volvulus, intussusception or very rarely as a complication of Littre's hernia (2, 3, 5). Its diagnosis is usually difficult despite the availability of modern investigative tools. A high index of suspicion is mandatory. In most cases it is an incidental finding. Hernial obstruction and strangulation of Meckel's diverticulum (Littre's Hernia) is a rare phenomenon and representing 10% of all complications of Meckel's diverticulum (6, 7). Surgery is the mainstay of treatment. We herein present an extremely rare case of strangulated Meckel's diverticulum in a Ventral Hernia (Littre's Hernia) which only became evident during surgery. The ventral hernia developed following emergency appendicectomy operation done for acute appendicitis 5 months back.