Strangulated Littré hernia. Case study

Abstract

A Littré hernia is defined as the presence of a Meckel's diverticulum in any hernial sac; it is a rare complication. Its incidence is unknown, and few cases are reported in the international literature. Most are discovered incidentally during elective hernia repair. The significant aspect of this patient is that she presented as an emergency case with strangulation of the diverticulum in the left inguinal region. There are no prior publications at the "Héroes del Baire" General Teaching Hospital in Isla de la Juventud and very few in Cuba. The patient is a 79-year-old woman with a history of hypertension, Parkinson's disease, and a left inguinal hernia of several years' duration. She presented to the emergency department with an irreducible, painful swelling and discoloration of the hernia, which had been present for 20 hours, accompanied by copious, foul-smelling vomiting. She was diagnosed with a strangulated inguinal hernia and taken to the operating room for surgery. During the procedure, upon opening the hernial sac, dark fluid was released, and a small loop of bowel with a necrotic diverticulum was observed. Intestinal resection and anastomosis were performed; she recovered satisfactorily and was discharged on the eleventh postoperative day. At postoperative visits at 15 days, 1 month, and 3 months, she continued to recover satisfactorily without complications, and was discharged three months postoperatively.