Non-Meckel Ileal Diverticulum Incarcerated Within a Strangulated Inguinal Hernia: A Case Report

Non-Meckel small bowel diverticula, particularly ileal diverticula, are rare, especially when incarcerated within an inguinal hernia sac. This case involves an 80-year-old man who presented with a newly noticed tender, irreducible lump in his left groin, accompanied by symptoms of bowel obstruction such as inability to pass flatus and vomiting. His medical history included a previous right inguinal hernia repair. Physical examination and laboratory tests indicated a strangulated hernia, which was confirmed by a contrast-enhanced computed tomography scan showing small bowel obstruction at the neck of the left inguinal hernia. The patient underwent a laparoscopic mesh repair, during which a non-Meckel ileal diverticulum was discovered within the hernia sac alongside a bruised but viable segment of the small bowel. The incarcerated diverticulum was gently reduced, and the hernia was successfully repaired using a mesh. The patient had an uneventful recovery and was discharged in a stable condition. This case highlights the importance of considering rare causes of small bowel obstruction in elderly patients presenting with hernias. Prompt imaging and surgical intervention are crucial to prevent serious complications such as bowel ischemia and perforation. The successful laparoscopic approach demonstrated minimal invasiveness and facilitated a swift postoperative recovery, underscoring its effectiveness in managing such uncommon clinical scenarios.