Gastrointestinal perforation due to incarcerated Meckel’s diverticulum in right femoral canal

Abstract

Meckel’s diverticulum is a very common congenital anomaly of the gastrointestinal tract but many cases remain asymptomatic and are diagnosed incidentally during laparoscopic or other surgical procedures. Cases of femoral hernia involving Meckel’s diverticulum are rare, with less than 50 cases reported in the literature since Littre published the first description of this coincident condition over 300 years ago. While all true “Littre’s hernias” contain a Meckel’s diverticulum, the involved anatomical sites are various, the most common being the inner groin (inguinal), the outer groin (femoral), and the belly button (umbilical). Complications of Littre’s hernias include incarceration, strangulation, necrosis, and perforation. Herein, we describe a case of Littre’s hernia that involved an incarcerated Meckel’s diverticulum in a femoral hernia that was diagnosed upon investigation of symptomology manifesting from perforation and was successfully managed by surgical resection with stapler devices.

Keywords: Meckel’s diverticulum; Incarceration; Littre Hernia; Gastrointestinal perforation

Core tip: Meckel’s diverticulum is most commonly diagnosed congenital anomaly of the gastrointestinal tract. Any hernia containing a Meckel’s diverticulum is designated as a Littre’s hernia. Although rare in overall incidence, the most common complications of Littre’s hernias are perforation, bowel obstruction secondary to strangulation, and incarceration within the hernial sac. In this case study, we present and share the diagnosis and successfully management of a case of incarcerated Meckel’s diverticulum in a femoral hernia (Littre’s hernia) with perforation.