Strangulated Umbilical Littre's Hernia In A Paediatric Patient: A Case Report

摘要

Littre's hernia is rare and often only discovered when complications arise. We report a case of strangulated umbilical Littre's hernia in a child. The patient was a 2-year old boy admitted for painful umbilical swelling. There was no fever. A surgical exploration found a strangulated Meckel's diverticulum. We proceeded with an ileum resection. The postoperative course was normal. Introduction Meckel's diverticulum (MD) is the most common anomaly of the gastrointestinal tract. It occurs in 0,3 to 3% of the general population [1]. It is often discovered in surgery because of some complications. Any hernia containing MD is named Littre's hernia. Strangulated umbilical Littre's hernia is very rare. We report a case with this condition. Case report A 2-year old boy was admitted to the Emergency Unit of the Regional Hospital of Thiès with a 10 hours history of painful umbilical swelling with vomiting. The Child did not have any episode of gastrointestinal bleeding or fever. Physical examination revealed an irreducible painful umbilical swelling. The laboratory tests were normal. No imaging examination was done. Under general anesthesia, the contents of the hernial sac were found to be a loop of ileum with a diverticulum on the antimesenteric side. There was no gangrenous tissue. There was also an adhesion between the diverticulum and the hernial sac and a hematoma on the mesenteric side (figure 1). A resection was performed to remove 10 cm of the small bowel on both sides of the MD followed by an immediate end-to-end anastomosis. The postoperative course was normal. The boy was discharged 7 days after the surgery in good clinic condition. On his 3 months follow-up he was well with no complaints. Histological study confirmed MD with heterotopic gastric mucosa without mucosal infarctions.