There are few cases published in the literature and its frequency. The sac comes through a hole or weak area in the strong layer of the belly wall that surrounds the muscle. Volume 69, issue 6, novemberdecember 2017, pages 495497. Littres hernia in a paediatric patient qin d, liu g, wang. Pdf incarcerated obturator hernia in 49 year old women. Littre s hernia is incarcerated meckels diverticulum in femoral, inguinal, or umbilical hernia. Littre hernias have a much broader spectrum of hernia site and occur. It occurs in places where, for anatomical reasons, gaps in the abdomen exist, as for instance in the groin, at the navel, at the edge of straight strains of abdominal muscles, or at lesions as they occur after abdominal surgery around scars in the abdominal wall. Littre hernia lh is the protrusion of a meckel diverticulum md through a potential abdominal opening with a container sac. Select up to 20 pdf files and images from your computer or drag them to the drop area. The hernial sac contains two loops of bowel with another loop of bowel being intraabdominal. Introduction the littre hernia is a rare complication of meckels diverticulum.
This does not represent a greater incidence of meckels diverticulum in women but rather the greater incidence of femoral hernia. As reported, right side occurred much more than the left side. This blind segment or small pouch is about 36 cm 2 inch long and may have a greater lumen diameter than that of the ileum. Erdinc kamer, atilla orsel, ahmet er, fevzi cengiz, mesut ozogul, and mustafa peskersoy. Critical to the repair of richters hernia is an adequate evaluation of the intestine for viability. Littre hernia definition of littre hernia by medical dictionary. Littre hernia is the protrusion of a meckel diverticulum through a potential abdominal opening. Littres hernia is the presence of a meckel diverticulum within an orifice in the abdominal wall. 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. Lipoma of the spermatic cord, fatty herniation, liposarcoma. Mayo repair what is nyhus classification of groin hernia. The littre hernia is a rare condition, but the surgeons must be aware of it. Hiatal hernia occurs when the upper part of the stomach slides up into the chest through a small opening in the diaphragm called the diaphragmatic hiatus. Littre s hernia lh is a condition defined by the presence of a meckel diverticulum md inside a.
This free and easy to use online tool allows to combine multiple pdf or images files into a single pdf document without having to install any software. Which type of hernia you have depends on where it is. Uncommon in other animals, abdominal wall hernias are among the most. A littres 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. This free online tool allows to combine multiple pdf or image files into a single pdf document. 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.
Split or extract pdf files online, easily and free. Jul 22, 2014 makalah hernia dr dr koernia swa oetomo sp. You may continue the ice after 24 hours if you feel it is helpful. The objective of this study is the evaluation of the current evidence on littre s hernias regarding their clinical presentation and optimal treatment approach. Split a pdf file by page ranges or extract all pdf pages to multiple pdf files. Discharge instructions after hernia repair central texas surgical associates 1. A md protrude through any potential abdominal opening is called littre s hernia. Meckels diverticulum is the most common congenital anomaly of the gastrointestinal tract. It is a rare condition and represents 1% of all the inguinal hernia pathology. Majority of abdominal wall hernias occur in the groin 75% of inguinal hernia repairs, 90% are performed in males and 10% in females.
Hiatus hernia is a protrusion of the stomach through the diaphragmatic hiatus. The term hernia is derived from the greek word hernios, which means budding. He was the first to give a description of a hernial protrusion of an intestinal diverticulum. Bowel obstruction and local inflammation are the possible complications. It is characterized by the presence of meckels diverticulum in the hernial sack. Inguinal hernia is the most common condition in both male and female subjects.
This will help to control your pain and bruising after the operation. Risk factors and prevention of incisional hernia repub, erasmus. A strangulated hernia occurs when the vascular supply of the bowel is compromised secondary to incarceration of hernia contents. Amyands hernia inguinal hernia appendectomy hernia sac. Inguinal hernia classifications need to reflect this reality. Interparietal interstitial hernia refers to a hernia sac located in the fascial planes between the abdominal wall muscles that does not exit into the subcutaneous tissue. There are few cases published in the literature and its frequency is not well described. A 19 years old male, came with pain and swelling in right inguinal region, which turned out. Littres hernia lh is a condition defined by the presence of a meckel. The diverticulum was resected with a 12 cm free margin.
This is not a contest to see who can put up with the most pain. Should an appendectomy be performed for the treatment of. The precondition for the formation of this particular hernia, as stated by richter, is determined by the size and consistency of the hernial orifice. Littres hernia lh is a condition defined by the presence of a meckel diverticulum md inside a hernial sac. Pubmed and cochrane bibliographical databases were searched.
The antimesenteric border of the intestine must protrude into the hernia sac the most common location is at the site of a femoral hernia. Symptoms, causes, diagnosis, and treatment definition and overview hernia is a general medical term used to describe a condition in which fatty tissue or an internal organ squeezes through a weak spot in the supporting muscle or connective tissue. Although umbilical hernia and femoral hernia have also been reported, the most common site is the inguinal canal. Simultaneous presentation of a right littres hernia and a. In this research, we present the details of diagnosis. Medial hernia definition of medial hernia by medical dictionary. A soft vascial hernia is a protrusion in an area of the abdomen. Most hernias are asymptomatic, but an increased incidence of acid reflux may lead to symptoms of gastroesophageal reflux disease gerd.
Any hernia sacs containing meckels diverticulum is called littres hernia. The recent report of baum and oich 6 is remarkable for the fact that the littre hernia involved the left femoral orifice. A hernia containing meckels diverticulum is called a littre s hernia. Littre s hernia is a very rare condition, reported only in 50 cases till date.
Merge pdf online combine pdf files for free foxit software. Metaanalysis of sublay versus onlay mesh repair in incisional hernia surgery. This type of hernia is more prone to strangulation and necrosis. Having its own blood supply, meckels diverticulum is susceptible to obstruction or infection. 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 rare case of acquired transthoracic littres hernia europe pmc. Meckel diverticulum as the sole component of the hernia sac. Simultaneous presentation of a right littre s hernia and a. Hernia protrusion of visceral contents through the abdominal wall. Hiatal hernia san jose minimally invasive surgery san. Amyands hernia is characterized by the presence of the cecal appendix, swollen or not, inside the inguinal hernia sac. An inguinal hernia appears as a bulge on one or both sides of the groin. S assistant professor, dept of general surgery, psgimsr. This is more convenient, less expensive and simpler.
To avoid medicolegal consequences, they now should also be considered hernias. An inguinal hernia occurs in the grointhe area between the abdomen and thigh. Minimal metabohc et suygery institute of minimal access. Maydl hernias are defined as the presence of two small bowel loops within a single hernial sac, that is, there are two efferent and two afferent loops of bowel, forming a w shape. Patient information for procedures melbourne hernia clinic. 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. Littre s hernia is the presence of a meckel diverticulum within an orifice in the abdominal wall. Hernia definition a hernia is a sac formed by the lining of the abdominal cavity peritoneum. This article reports the discovery during an inguinal herniorraphy in a four years old patient of a meckel. The standard treatment of littre hernia is a wedge resection of the meckel diverticulum and hernia repair.
Learning points meckels diverticulum is the most common congenital anomaly of the gastrointestinal tract. An ulcerated diverticulum embedded in the umbilical hernia littre hernia was dissected free from the hernial sac. Meckel diverticulum md is the most frequently seen. Littre hernia an occasional cause of acute abdomen. If the neck becomes pinched tight enough to cut off the blood supply, the hernia will quickly swell and become strangulated. It is most frequently encountered in the inguinal region. Upon discharge from the hospital, the day of surgery it is requested that you do no significant physical activity and limit mental activities. Pdf introduction incarcerated obturator hernia is a rare cause of bowel obstruction. Treatment is directed at symptoms of gerd if present. Since median incisions in the abdomen are frequent for abdominal exploratory surgery, ventral incisional hernias are often also classified as ventral hernias due to their location. A rare case of an incarcerated meckels diverticulum authors brian malling1, andreas aarenstrup karlsen2, jesper hern3 affiliations 1 rigshospitalet, department of diagnostic. We present the unique case of an elderly woman with acute abdomen secondary to the coexistence of both these conditions. A case of an elderly, obese male with a giant cord lipoma who underwent excision of a large, irreducible, complete, sliding, sacless, indirect fatty inguinal hernia is detailed.
Abstract the case report of a 47 years adult is described who went to the em ergency room of. Littre hernia is a hernia containing a meckel diverticulum, and is also known as a persistent omphalomesenteric duct hernia. In the early twentieth century there appeared to be some confusion again regarding littre. Abd wall hernias university of tennessee college of medicine. Meckels diverticulum is located in the distal ileum, usually within 60100 cm 2 feet of the ileocecal valve. Maydls hernia hernia inw is a rare type of hernia and may be lethal if undiagnosed. Its a rare entity and its diagnosis is often incidental during routine hernia repair surgery. Herein, we present a rare case of md which was detected during elective inguinal. Although lh is commonly seen in emergency surgeries such as incarceration and obstruction or hemorrhage, it is rare in elective surgeries. The diaphragm is the domeshaped muscle separating the abdomen from the chest. An incisional hernia is a type of hernia caused by an incompletelyhealed surgical wound.
In the year 1700, the french surgeon alexis littre was the first to describe cases of incarcerated femoral hernias containing a small bowel. A rare case of an incarcerated meckels diverticulum. Meckel diverticulum and obturator hernia are rare causes of intestinal obstruction. Littre hernia lh is defined as the presence of md in a hernia sac. Richters hernia, after august richter, describes a hernia where only a part of the bowels circumference is incarcerated. Meckel diverticulum md is the most frequently seen congenital anomaly of the gastrointestinal system.
Department of surgery, izmir katip celebi university, turkey. We are presenting a case of strangulated littre s hernia. Scribd is the worlds largest social reading and publishing site. Get a printable copy pdf file of the complete article 564k, or click on a page image below to browse page. Simultaneous presentation of a right littres hernia and a left. The finding of both of these anatomical structures in the same hernia is exquisitely rare and infrequently described. Combine multiple pdf files into one pdf, try foxit pdf merge tool online free and easy to use. The alternative is to have the procedure done in hospital with or without sedation. Littre herniaincarcerated meckels diverticulum sciencedirect. As any hernia progresses and bulges out through the weak point in its containing wall, the opening in the wall tends to close behind it, forming a narrow neck.
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