scholarly journals Perforated Incisional Littre’s Hernia: A Rare Content of a Common Hernia

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Kumarappan Al ◽  
Norly S ◽  
Samuel Tay ◽  
Vicknesh C

Anticipation of complications is of paramount importance for a surgeon. Incisional hernia is a well-known complication for abdominal surgeries. Risk factors such as increasing age, obesity, male gender are well known. Intestinal obstruction, strangulation and perforation are imminent complications of this type of hernia if they become incarcerated. Common contents of a ventral incisional hernia are small bowel, large bowel and omentum. Even though Meckel’s diverticulum is a common gastrointestinal anomaly, it is rarely found to be the content of a hernial sac. A hernia sac containing Meckel’s diverticulum is also known as Littre’s hernia. Only a few cases have been reported in the literature. Thus here we present a case of perforated Meckel’s diverticulum that was entrapped in the ventral incisional hernia.

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mihiri Wettasinghe ◽  
Kumari Pussepitiya ◽  
Bandula Samarasinghe ◽  
Nuwan Wickramasinghe

Introduction. Vitelline artery remnants are rare causes of intra-abdominal bands leading to bowel obstruction. These bands may be associated with Meckel’s diverticulum. Double inferior vena cava (IVC) is a rare presentation and is usually identified incidentally. Case Presentation. A sixty-year-old male presented with progressive vomiting for five days and he was clinically diagnosed with intestinal obstruction. Plain X-ray abdomen showed evidence of small bowel obstruction. CT scan of the abdomen revealed dilated small bowel loops with a small outpouching in the distal ileum with a band like structure attached to it. In the CT, left sided patent IVC draining into the left renal vein was identified. Left external iliac vein was in continuity with the left IVC. Left internal iliac vein was draining into the right IVC. Exploratory laparotomy revealed a Meckel’s diverticulum with a band identified as the vitelline remnant attached to its apex and inserting at the anterior abdominal wall near the umbilicus. Discussion. Meckel’s diverticulum with vitelline bands, although rare, should be borne in mind in adult patients with intestinal obstruction. Identification of this anomaly can be difficult in imaging studies. Presence of double IVC should be mentioned in the imaging findings to prevent possible catastrophic complications during surgery.


2018 ◽  
Vol 5 (8) ◽  
pp. 2929
Author(s):  
Vergis Paul ◽  
Ramu R. ◽  
Kocheril Sheryl Mathews ◽  
Ashly Thomas ◽  
Reesha P. A. ◽  
...  

The Meckel's diverticulum is a congenital diverticulum arising from the terminal ileum and is the unobliterated proximal portion of the vitellointestinal duct. Intestinal obstruction due to Meckel’s diverticulum is the most common presentation in adults and is the second most common presentation in children. We present a case of a 58-year-old gentleman presented with acute abdomen who was later found to have Giant T- shaped Meckel’s Diverticulum complicating small bowel volvulus on exploratory laparotomy. A T-shaped Meckel's diverticulum has not yet been described.


2021 ◽  
Vol 8 (6) ◽  
pp. 1904
Author(s):  
Aishwarya Emerald Manohar ◽  
M. S. Kalyan Kumar ◽  
V. Vijayalakshmi ◽  
R. Kannan

Intestinal malrotation is the partial or complete failure of rotation of midgut around the superior mesenteric artery, while Meckel’s diverticulum is the remnant of vitellointestinal duct and concurrence of these congenital abnormalities in an adult is considered a rarity. Till date only 3 cases of concurrent intestinal malrotation and Meckel's diverticulum have been reported. We report a 18 years male who presented with a 3 day history of abdominal pain, bilious vomiting, obstipation and chronic abdominal pain on and off since 3 years of age. During the last episode which occurred 1 year back, he was diagnosed with intestinal malrotation with subacute intestinal obstruction and was treated conservatively. Examination revealed the presence of signs of peritonitis. After resuscitation, CECT abdomen was taken which showed dilated small bowel loops in the subhepatic region associated with malrotation. Emergency laparotomy revealed a Ladd's band below which the gangrenous small bowel loops 150 cm from the duodenojejunal (flexure until 5 cm proximal to the ileocecal junction) were found herniating into the subhepatic region with a Meckel’s diverticulum and a right sided DJ flexure. We proceeded with the band release and resection of gangrenous bowel followed by proximal jejunostomy with distal ileostomy. HPE was consistent with Meckel’s diverticulitis without any ectopic gastric or pancreatic mucosa. Ostomy reversal was done after 8 weeks. Patient had an uneventful postoperative recovery during both the admissions and he is on regular follow-up now.


2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Umasankar Mathuram Thiyagarajan ◽  
Amirthavarshini Ponnuswamy ◽  
Atul Bagul ◽  
Prabakar Ponnuswamy

Meckel’s diverticulum is the commonest congenital malformation of gastrointestinal tract and represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, it can present as bleeding, perforation, intestinal obstruction, intussusception, and tumours. These complications, especially bleeding, tend to be more common in the paediatric group and intestinal obstruction in adults. Stone formation (lithiasis) in Meckel’s diverticulum is rare. We report a case of Meckel’s diverticulum lithiasis which presented as an acute abdomen in an otherwise healthy individual. The patient underwent an exploratory laparotomy which revealed a perforated Meckel’s diverticulum with lithiasis; a segmental resection with end-to-end anastomosis of small bowel was performed. Patient recovery was delayed due to pneumonia, discharged on day 20 with no further complications at 6 months following surgery.


2017 ◽  
Vol 4 (4) ◽  
pp. 1481 ◽  
Author(s):  
Prakash Kumar Sahoo ◽  
Suman Saurav Rout

Littré’s hernia is caused by the protrusion of Meckel’s diverticulum through an orifice in the abdominal wall. Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract that is generally asymptomatic and only manifests in a specific way when complications exist. An unusual complication of Meckel’s diverticulum is known as Littre’s hernia. It comprises less than 1% of all Meckel’s diverticulum. Usual sites of Littre hernia are right inguinal (50% of cases), umbilical hernia (20%), and femoral hernia (20%). We present a case of Littré’s hernia where we found a strangulated Meckel’s diverticulum in an inguinal hernia sac.


2019 ◽  
pp. 1-2
Author(s):  
Soledad Aguado Henche ◽  
Hernández Fernández L.M ◽  
Slocker de Arce A ◽  
Díaz Pedrero R

Meckel's diverticulum it is the most common malformation of the gastrointestinal tract. Femoral hernia is the second most common inguinal hernia, and is characterized by incarceration and strangulation. We present a case of 90-year-old woman wiht strangulation of Meckel’s diverticulum in a left-sided femoral hernia. The diverticulum was resected and hernia was repared wihtout complications. A Littre’s hernia is a complication of Meckel’s diverticulum and it is a result of its protrusion through a herniary orifice. Surgical resection is recommended for this type of hernia due to possible vascular complications, intestinal obstruction and herniation. Although usually Littre’s hernia appears in the early ages of the life, we must not ignore their possible appearance in people who are aged. We present in this case a Littre’s hernia in a very old woman.


2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Vishnu M ◽  
Oon MJ ◽  
Heah HT ◽  
Huzairi Y ◽  
Nil Amri ◽  
...  

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.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Khalida Itriyeva ◽  
Matthew Harris ◽  
Joshua Rocker ◽  
Robert Gochman

Physicians are educated with the classical teaching that symptomatic patients with Meckel’s diverticulum (MD) most often present with painless rectal bleeding. However, a review of the literature reveals that young patients with MD will most commonly present with signs of intestinal obstruction, an etiology not frequency considered in patients presenting to the emergency department with obstruction. We present two cases of intestinal obstruction diagnosed in our emergency department, with Meckel’s diverticulum being the etiology.


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