The Strangulated Littré Hernia in an Elderly Patient. An Interesting and Rare Case

Aim The aim of this study is to report a highly intriguing case of Littré hernia, since there are few articles concerning this specific type of hernia published in the international literature. Littré’s hernia is a type of hernia where Meckel’s diverticulum is present in the hernia sac. Meckel’s diverticulum, an embryonic remnant of the vitelline duct, is found in around 0.3–2.9% of the general population. It is located at the antimesenteric aspect of the small intestine, typically positioned 30–90 cm away from the ileocecal valve. Material and Methods An 88-year-old patient presented in the Emergency Department of 424 General Military Hospital of Thessaloniki with signs and symptoms indicative of a strangulated inguinal hernia. The radiological findings were also consistent with the diagnosis, depicting the presence of ileus. Results The patient was transported to the operating room, where examination of the hernial sac revealed the existence of a strangulated, yet vital, segment of the small intestine along with Meckel’s diverticulum. Consequently, resection of Meckel’s diverticulum, as well as appendectomy were performed, followed by the placing of a polypropylene mesh in the orifice of the abdominal wall (Lichtenstein method). The postoperative period was considered uneventful and the patient was discharged on the 7th postoperative day, primarily due to comorbidities. Conclusion Littré’s hernias, although rare, can be present as abdominal hernias. Resection of Meckel’s diverticulum, along with repair of the fascial defect is crucial for preventing future complications associated to the diverticulum, such as obstruction, infection, bleeding or herniation.