Surgical treatment of Littre hernia in a 6-month old child

Abstract

Introduction. A surgical care in complicated hernias of the anterior abdominal wall remains an acute issue in pediatric surgery. Strangulated hernia is the most common and dangerous complication. It is worth mentioning that the risk of developing this complication in children during the first six months of their life reaches 24%. The clinical course of strangulated hernia in children is characterized by a large variety of symptoms depending on patient’s age, anatomical and pathomorphological features of his/her organs and systems. A correct assessment of clinical, laboratory and instrumental findings can help in identifying uncommon types of hernia infringement.Material and methods. A case of clinical observation and surgical treatment of a 6-month old child with Littre hernia is presented.Results. By the literature data, emotional and motor restlessness prevails in the structure of complaints in infants with strangulated hernia. Patients with uncommon types of hernia infringement may be regarded as a separate group. Patients with Littre hernia, which is one of the types of parietal infringement, belong to this group. Littre hernia incidence does not exceed 0.5% of the total number of hernia strangulations. Clinical symptoms of the atypical hernia infringement may be mild or non-classical. It is known that mild clinical manifestations of strangulated hernia as well as limited diagnostic potentials of laboratory, X-ray and ultrasound examinations in young children increase the risk of developing destructive changes in the intestinal wall. Therefore, an active surgical tactics of hernia treatment prevents the development of atypical forms of hernia infringement and complications associated with it.Conclusion. Thus, early detection of hernias of the anterior abdominal wall, since the neonatal period, an adequate observation tactics and timely performed surgical intervention is the basis for preventing peritonitis and intestinal obstruction in young children.