Littre's hernia: literature review

Abstract

Littré's hernia is a rare finding with less than 100 cases reported in the literature that is described as the presence of a Meckel's diverticulum within a hernial sac. Its incidence is unknown, but it has been reported that 1% of patients with Meckel's diverticulum will develop a Littré's hernia. Although Meckel's diverticulum is more common in men, Littré's hernia presents similarly in both men and women and is typically exhibited as a femoral, inguinal, and umbilical hernia. Littré's hernia may remain asymptomatic, being diagnosed incidentally during surgery, present with non-specific symptoms and signs such as abdominal pain, bloating, nausea and vomiting, or develop a complicated picture such as strangulation, incarceration, perforation and enterocutaneous fistula. Its definitive diagnosis is usually found intraoperatively during hernia repair. Treatment is surgical and includes repair of the hernia defect and management of Meckel's diverticulum. Resection of Meckel's diverticulum is indicated in cases of complicated Littré's hernia, but resection in the context of an incidentally found asymptomatic Meckel's diverticulum is a particular case that poses therapeutic dilemmas.