The definition of littres hernia is based upon the protrusion of a md through a potential abdominal opening accompanied in some cases by incarceration, inflammation, or necrosis. Review littres hernia the american journal of surgery. An inguinal hernia occurs in the grointhe area between the abdomen and thigh. Meckel diverticulum as the sole component of the hernia sac. Full text is available as a scanned copy of the original print version. There are few cases published in the literature and its frequency is not well described. An indirect inguinal hernia is a congenital lesion. In recent years, reports of littre hernia are usually made on cases of a meckels diverticu lum in a femoral hernia 2, although correctly a meckels diverticulum in any other hernial. Littres hernia, an incarcerated ventral incisional hernia. Volume 69, issue 6, novemberdecember 2017, pages 495497.
Scribd is the worlds largest social reading and publishing site. A large incarcerated meckels diverticulum in an inguinal hernia. Alexis littre 17 july 1654 3 february 1726 was a french physician and anatomist born in cordes currently cordestolosannes in the department of tarnetgaronne. Littre s hernia 11% is an unusual complication of a meckel diverticulum.
Littre hernias are commonest in the inguinal region and may cause bowel obstruction secondary to strangulation or incarceration of the diverticulum within the hernial sac. In 1719 alexis littre described a hernia bearing his name. Littres hernia lh is a condition defined by the presence of a meckel diverticulum md inside a hernial sac. The processus vaginalis must be patent for this type of hernia to occur. Littre hernia is the protrusion of a meckel diverticulum through a potential abdominal opening. The authors report one case of littres hernia in a 42 yearold male who had the diagnosis accomplished in the intraoperative. Meckels diverticulum is the most common congenital anomaly of the gastrointestinal tract,1 but the occurrence of a littres hernia is an extremely rare condition.
Links to pubmed are also available for selected references. Histopathological examination showed herniation of the meckel diverticulum littre hernia. Our patient has been operated as incarcerated inguinal hernia and littre hernia diagnosed at operation. Ileal atresia secondary to antenatal strangulation of littre. Littre s hernia was originally defined as the presence of a meckels diverticulum in any hernia sac by rieke in 1841. Meckels diverticulum is the most common congenital anomaly of the gastrointestinal tract. Littre hernias are usually presented as inguinal, femoral and umbilical hernias 5. Its a rare entity and its diagnosis is often incidental during routine hernia repair surgery. A small exomphalos minor at the base of the umbilical cord can be missed even in the postnatal period. Any hernia containing meckels diverticulum is classified as a littre hernia.
Inguinal hernia is the most common condition in both male and female subjects. The antimesenteric border of the intestine must protrude into the hernia sac the most common location is at the site of a femoral hernia. In recent years, reports of littre hernia are usuaiiy made on cases of a meckeis diverticuium in a femora1 hernia 2, ahhough correctly a meckeis diverticuium in any other hernia1 orifice wouid. If the meckels diverticulum a congenital pouch formation on the small intestine pushes into a hernia sac, the hernia is called a littre s hernia. Since then the presence of meckei s diverticu ium in a hernia sac anywhere is aiso caiied littre s hernia. It is most frequently encountered in the inguinal region. Littre hernia lh is the protrusion of md through a potential abdominal opening. Modified tensionfree mesh repair used in rare case of. Surgical resection is recommended for this type of hernia due to possible vascular complications, intestinal obstruction and herniation. Critical to the repair of richters hernia is an adequate evaluation of the intestine for viability. It is a rare condition and represents 1% of all the inguinal hernia pathology. It is a rare finding at any age, and its true incidence is unknown. The triad of exomphalos minor, meckels diverticulum and terminal ileal atresia secondary to antenatal strangulation of littre s hernia is very rare to find in the same patient.
Ileal atresia secondary to antenatal strangulation of. Abstract intestinal obstruction due to incarcerated meckels. A hernia containing meckels diverticulum is called a littres hernia. Littres hernia definition of littres hernia by medical. A hernia pode ser classificada em diversas maneiras diferentes mas as categorias as mais comuns sao descritas abaixo.
Pubmed and cochrane bibliographical databases were searched. Sep 15, 2012 a 4 cm transverse incision above the umbilicus allowed repair of the hernia as well as small bowel resection because the diverticulum was located at the umbilical hernia. Since then the hernia sacs containing only meckels diverticula are termed as littre s hernia. Strangulation of a meckels diverticulum in a femoral hernia littre s. Get a printable copy pdf file of the complete article 720k, or click on a page image below to browse page by page. A hernia that contains a meckels diverticulum in the sac. The area was drained and small intestinal contents found. Littre hernias typically occur in the inguinal region, and they may cause bowel obstruction secondary to strangulation or incarceration of the diverticulum within the. Onuigbo wib, medical foundation and clinic, 8 nsukka lane, enugu 400001, nigeria, email. This is a report of the first case, to my knowledge, of a richter hernia occurring in a sacral foramen. Get a printable copy pdf file of the complete article 720k. Intestinal obstruction due to incarcerated meckels. The herniation of a meckels diverticulum was first described by the french surgeon alexis littre in 1700,2 and have less than 50 cases described in the literature over the past 300 years.
Symptoms of a littre s hernia are similar to symptoms of a strangulated or incarcerated hernia. A rare case of an incarcerated meckels diverticulum. Littre hernia definition of littre hernia by medical dictionary. Inguinal hernia this is the most common form of hernia and makes up 75% of all abdominal. Littre hernia a technetium99m pertechnetate scintigraphy. He was the first to give a description of a hernial protrusion of an intestinal diverticulum.
Hernia can be classified in several different ways but the most common categories are described below. Abd wall hernias university of tennessee college of medicine. The objective of this study is the evaluation of the current evidence on littre s hernias regarding their clinical presentation and optimal treatment approach. Appendicitis and meckels diverticulum in a femoral hernia. Amyands hernia is characterized by the presence of the cecal appendix, swollen or not, inside the inguinal hernia sac. A littres hernia is a complication of meckels diverticulum and it is a result of its protrusion through a herniary orifice. Modified tensionfree mesh repair used in rare case of littre s hernia. Surgical findings included hernial sac contents with loop of ileum with signs of ischemia and a meckels diverticulum. Littre s hernia lh is a condition defined by the presence of a meckel diverticulum md inside a.
Littres hernia is a rare finding consisting of a meckels diverticulum inside of a hernia sac. An inguinal hernia appears as a bulge on one or both sides of the groin. A 4 cm transverse incision above the umbilicus allowed repair of the hernia as well as small bowel resection because the diverticulum was located at the umbilical hernia. Meckel diverticulum is the commonest congenital anomaly of the gastrointestinal tract. This is a hernia through the linea semilunaris at the lateral border of the rectus sheath. A littre hernia occurs in less than 1% of patients with a md. It is distinct from amyands hernia, in which the appendix is within an inguinal hernia sac.
Pdf meckel diverticulum md is the most common congenital anomaly of the. A littre hernia is a rare complication of meckels diverticulum and it is a result of its protrusion through a herniary orifice. The objective of this study is the evaluation of the current evidence on littres hernias regarding their clinical presentation and optimal treatment approach. In the year 1700, the french surgeon alexis littre was the first to describe cases of incarcerated femoral hernias containing a small bowel. Its incidence is yet unknown, but is reported that 1% of patients having a meckel diverticulum will develop a littre hernia. She underwent successful operative management and was discharged from hospital on the 10th postoperative day. The usual sites of these socalled littre hernias are inguinal 50%, umbilical 20%, and femoral 20%. Simultaneous presentation of a right littre s hernia and a. The diverticulum was resected with a 12 cm free margin.
Simultaneous presentation of a right littres hernia and a. Jul 06, 2018 70is yo female complaining of right sided groin pain and bloody stools. The definition of littre s hernia is based upon the protrusion of a md through a potential abdominal opening accompanied in some cases by incarceration, inflammation, or necrosis. Clinically, it is indistinguishable from a hernia involving small bowel. Although littre s original report related to femoral hernias, 50% of the meckels diverticula are in inguinal hernias, 20% in femoral, 20% in umbilical and remaining 10% in other miscellaneous hernias 6, 7, 8. Littres hernia is an extremely rare surgical event. The diverticulum was resected and hernia was repared wihtout complications. This type of hernia is called inguinal because fat or part of the intestine slides through a weak area at the inguinal ring, the opening to the inguinal canal. A hernia containing meckels diverticulum is called a littre s hernia. An ulcerated diverticulum embedded in the umbilical hernia littre hernia was dissected free from the hernial sac.
A littre s hernia is an abdominal wall hernia that involves the meckels diverticulum, which is a congenital pouch formation on the small intestine that contains tissue leftover during the formation of the digestive tract and its organs. The diverticulum was resected with a 12 cm free margin on both sides and the intestine was anastomosed endtoend. A littre s hernia is a rare type of hernia that is caused by a meckels diverticulum pushing through an abdominal wall opening and into an existing hernia sac. The most common site of littre s hernia is the inguinal canal, usually on the right. This hernia varied from the known forms of hernias in its clinical course and in the postmortem examination results performed by littre himself. It is characterized by the presence of meckels diverticulum in the hernial sack. Symptoms range from abdominal cramping, fever, nausea, and frequent vomiting to swelling of the groin hernia, intense pain, and hardening of the hernia bulge.
Littre s hernia is the presence of a meckel diverticulum within an orifice in the abdominal wall. Littre hernia is a hernia containing a meckel diverticulum, and is also known as a persistent omphalomesenteric duct hernia. Any hernia containing the meckel diverticulum is termed a littre hernia. The most common site of littres hernia is the inguinal canal, usually on the right. The article discusses the history and the incidence of this rare form of hernia. Indirect inguinal hernia an indirect inguinal hernia occurs when any intraabdominal structure protrudes through the deep inguinal ring entering the inguinal canal.
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