Management of a mixed Littre hernia

Area of Science:

• Gastroenterology
• Surgical Case Reports

Background:

• Littre hernia is a rare condition involving a Meckel's diverticulum within a hernia sac.
• Mixed Littre hernias, containing additional abdominal viscera, are exceptionally uncommon and typically discovered during surgery.
• The management of incidental Meckel's diverticula, whether intra-abdominal or within a hernia, is debated due to limited evidence.

Purpose of the Study:

• To report a case of a mixed Littre hernia.
• To discuss the management of Meckel's diverticulum found incidentally within a hernia sac.
• To highlight the need for further research and guidelines for managing such rare cases.

Main Methods:

• A case report of a right inguinoscrotal hernia repair in a male patient in his 60s.
• Intra-operative identification of a 10 cm Meckel's diverticulum and a loop of ileum within the hernia sac.
• Non-operative management of the identified Meckel's diverticulum.

Main Results:

• A mixed Littre hernia was identified during surgery.
• The Meckel's diverticulum was managed non-operatively without complications at 6 months follow-up.
• The patient had a 10 cm Meckel's diverticulum within the hernia sac.

Conclusions:

• Mixed Littre hernias are rare and often found incidentally during hernia repair.
• The optimal management strategy for Meckel's diverticula within hernia sacs requires further investigation.
• There is a need for evidence-based guidelines to assist surgical decision-making in these infrequent scenarios.