Littre hernia in adults: imaging features and clinical implications

Littre hernia is an inguinal or abdominal wall herniation that contains a Meckel's diverticulum alone or with other intestinal loops. The diagnosis is usually made at surgery, but its pre-operative radiological recognition has been a challenge due to inherent difficulties in detecting the Meckel's diverticulum within hernial content. The aim of this article is to present 8 adults in whom a Meckel's diverticulum protruding into their inguinal, umbilical or incisional hernia had been demonstrated by barium examination of the small bowel or colon, or on computed tomography and magnetic resonance imaging of the abdomen and pelvis. This series included 7 men and 1 woman, who ranged in age from 34 to 78 years (mean age:57 years). Seven patients had subsequent hernia repair, when the diverticulum was visualized and resected. This report highlights the imaging features of these 8 Littre hernias since only 5% of published cases had been diagnosed pre-operatively because the Meckel's diverticulum had resulted in complications. It also reviews the pertinent literature regarding the prevalence and clinical implications of this rare entity.