Inguinal Abscess in a Strangulated Littre's Hernia

Abstract

Background: Littre's hernia is the type of hernia where the sac contains Meckel's diverticulum, which is associated with various complications. Strangulation of Meckel's diverticulum and consequent rupture represents a serious and life-threatening condition. Methods: A 62-year-old female, with a 10-d history of abdominal pain, presented in the emergency department with abdominal pain in the past 48 h, accompanied by fever and vomiting. Clinical examination revealed diffuse abdominal pain and an inflamed mass on the right groin. Given the clinical and laboratory findings the patient was taken in the operating room. Results: Diagnostic laparoscopy revealed Littre's hernia accompanied by rupture of Meckel's diverticulum and abscess formation. Because of multiple adhesions and distension of the small bowel, the operation proceeded with open laparotomy, including a sub-umbilical midline incision. Enterectomy and side-to-side anastomosis was performed and the abscess was drained. The post-operative period was uneventful and the patient was symptom free at the two-month follow-up. Conclusions: An inguinal abscess can represent the first manifestation of a strangulated Meckel's diverticulum in Littre's hernia. It should be taken into account in the differential diagnosis of acute abdomen symptoms. Prompt diagnosis and therapy is essential. The preferred treatment is an operation consisting of enterectomy and primary anastomosis.