Littre hernia in childhood: A case report with a brief review of the literature

Abstract

A 3-year-old boy with a right-sided and painful inguinal swelling for the last 2 h was admitted to the emergency department. As there were no apparent peritoneal irritation findings, right-sided incarcerated inguinal hernia was reduced and the patient was scheduled for an elective herniorrhaphy. Perioperatively even though the sac seemed empty, it was opened in order to inspect its content. The adherence of Meckel's diverticulum (MD) to the base of hernial sac was realized and Littre hernia (LH) was diagnosed. The hernia was highly ligated after the wedge resection of the diverticulum and anastomosis. The patient was fed on the second postoperative day and discharged on the third postoperative day. Despite numerous presentations of LH in the adult age group in the literature, there are limited data about the disease in the childhood period. Even though the scarcity of the data, there are some so-called rules for LH in childhood like protruding more common through umbilical hernias, containing heterotopic tissues more frequent than adult age and incarcerating/strangulating more often. The aim of this study is to review the reported LH cases, present a new case and discuss the features of LH in childhood period.

İncarcereted Littre hernia in childhood: a rare case report with review of the literature

“…Pampal ve ark. (18) tarafından derlenen bir araştırmada; LH tespit edilen 68 çocuk olgunın 44'ünde MD'nin orta hat konjenital abdominal duvar defektinden, 23 olguda ise inguinal bölgeden herniye olduğu tespit edilmiştir. Hastaların tamamına manuel redüksiyon denenmiş olup; hastaların 3'ünde redüksiyon başarılı olmamış ve 3 olgu ise fekal fistül ile sonuçlanmıştır.…”

“…Ancak Pampal ve ark. 'nın (18) yaptığı olgu serisi çalışmasında ise inkarsere LH'li hastalarda manuel redüksiyonun başarı oranı %90'a yakın olarak bildirilmiştir. Redüksiyonun başarılı olmadığı olguların tamamında ise fekal fistül geliştiği belirtilmiştir.…”

“…Sıklıkla ağrı-sız kitle ile karşımıza çıkar (20) . LH'nin inkarserasyon ya da strangülasyon ile birlikteliği enderdir ve literatürde az sayıda olgu bildirilmiştir (18) .…”

“…Sıklıkla ağrı-sız kitle ile karşımıza çıkar (20) . LH'nin inkarserasyon ya da strangülasyon ile birlikteliği enderdir ve literatürde az sayıda olgu bildirilmiştir (18) .Bu yazıda, çocuklarda oldukça ender görülen inkarsere LH olan bir olgu sunuldu. Olgu sunumu ile birlikte çocukluk çağı LH inkarserasyonu ve tedavi yaklaşımı literatür eşliğinde tartışıldı.…”

Littre’s hernia with an impalpable testis in a boy: a diagnostic dilemma

“…However, Littre's hernia is quite rare in children accounting for 0–11% presentation of MD 5–10. In the literature, 70 cases of Littre's hernias in children have been reported since the early 1900s 9. We present an interesting case of Littre’s hernia with undescended testis, which created a diagnostic dilemma among clinicians preoperatively.…”