Strangulated Meckel’s Diverticulum in a Littre’s Hernia: A Rare Complication

Abstract

Meckel’s diverticulum occurs in 2-3% of general population and can presents as Littre’s hernia. We are reporting an 88-year-old female referred to our surgical unit with a painful right groin hernia 2 weeks, associated with vomiting, fever and diarrhoea. Physical examination showed an irreducible tender lump in the right groin with overlying erythematous skin. Plain radiograph showed dilated small bowel with a loop of bowel seen within the right groin region. A diagnosis of strangulated right femoral hernia was made preoperatively. Right inguinal incision initially employed, however, after a grossly inflamed Meckel's diverticulum with adjacent bowel perforation was found, a midline laparotomy ensues. Meckel's diverticulum was resected together with the perforated segment of small bowel. A primary anastomosis was then performed. In managing Meckel’s diverticulum the proposed treatment for is wedge resection and primary repair of the ileum. If there is oedema or inflammation at the base of the diverticulum, resection and anastomosis of a segment of the ileum may be necessary. Meckel’s diverticulum may be found in any type of abdominal hernia and thus an incarcerated hernia should not be attempted to manually reduce.