A large incarcerated Meckel's diverticulum in an inguinal hernia

INTRODUCTION

Littre''s hernia is a rare finding consisting of a Meckel''s diverticulum inside of a hernia sac. Clinically, it is indistinguishable from a hernia involving small bowel and therefore may be difficult to diagnose pre-operatively.

PRESENTATION OF CASE

We report a case of an inguinal hernia involving an unusually large Meckel''s diverticulum measuring 15 cm in length. The diverticulum was resected using a linear GI stapler and the hernia was repaired without complication.

DISCUSSION

Meckel''s diverticulum is an embryologic remnant of the vitelline duct occurring in 1–3% of the adult population with an estimated 4% becoming complicated and presenting with intestinal obstruction, infection, bleeding or herniation. Surgical resection is the recommended treatment for any Meckel''s diverticulum causing symptoms. In the case of a Littre''s hernia, resection of the diverticulum should be followed by repair of the fascial defect in a standard fashion.

CONCLUSION

Littre''s hernia, although rare, should be a consideration at the time of repair for any abdominal hernia involving small bowel as resection of the Meckel''s diverticulum is critical in avoiding recurrent complications.     

Laparoscopic reduction of incarcerated Meckel's diverticulum following abdominal hysterectomy.

BACKGROUND: Laparoscopic techniques are increasingly being utilized to diagnose and successfully manage intestinal obstruction. CASE REPORT: We describe a patient who presented with intestinal obstruction following a recent abdominal hysterectomy. The obstruction was caused by entrapment of a segment of small bowel containing a Meckel's diverticulum within a pouch formed by the peritoneal layer following mass closure of the abdominal wound. DISCUSSION: We discuss the literature on the abdominal wound closure technique. The role of laparoscopy in dealing with intestinal obstruction is reviewed briefly. We have also summarized the management of an incidental Meckel's diverticulum found at laparoscopy.     

A case of intussuscepted and incarcerated Meckel's diverticulum in to the cecum

BACKGROUND: Intussusception with the Meckel's diverticulum is rare cause of small bowel obstruction in the adults. The Meckel diverticulum is the most common cause of intestinal obstruction in children. METHODS (CASE REPORT): We present a case of 18-year-old boy with developing signs of small bowel obstruction The onset of disease was the day before the first examination. There was no hystory of prior surgery. According to the clinical symptoms, physical examinations as well as radiographic and ultrasound examination, surgical treatment was indicated. Surgical approach was inferior medial laparotomy. Intussusceptions of the Meckel's diverticulum and into the coecum with incarceration were found. Desincarceration and simple diverticulectomy was done. CONCLUSION: The Meckels's diverticulum should be consider as a possible cause of the small bowel obs-truction in previously healthy patient.     

Meckel's diverticulum duplication. Case report

Meckel's diverticulum is the most common congenital abnormality of the small intestine. A case of Meckel's diverticulum duplication is described, believed to be the first report of this kind in the literature.     

Meckel's diverticulum

Fifty cases of Meckel's diverticulum are presented and analyzed. The literature is consulted for comparison of this series with the series of other authors. The embryologic background is briefly given. The authors' experience in dealing with these patients is summarized and suggestions are made for improvement in diagnosis and treatment.     

Inverted Meckel's diverticulum causing intussusception in an adult

Adult intussusception is rare, making-up only about 1% of the causes of bowel obstruction intussusception, secondary to an inverted Meckel's diverticulum, is also a rare occurrence. Chronic abdominal pain, lower gastrointestinal bleeding, and recurrent obstructive symptoms may lead to an unnecessary delay in diagnosis. This case report describes a rare cause of adult intestinal intussusception due to inverted Meckel's diverticulum. Intussusception was diagnosed on emergency ultrasound of the patient, who was successfully managed with surgery.     

Coexistence of abdominal cocoon,intestinal perforation andincarcerated Meckel’s diverticulum in an inguinal hernia: Atroublesome condition

Sclerosing encapsulating peritonitis(SEP) is a rare dis-ease entity, in which the small intestine becomes en-cased and mechanically obstructed by a dense, fibrotic membrane. The disorder is characterized as either primary(idiopathic) or secondary to other causes. The idiopathic cases of SEP, which lack any identifiable eti-ology according to clinical, radiological and histopatho-logical findings, are also reported under the designation of abdominal cocoon syndrome. The most frequent presenting symptoms of all SEP cases are nausea, vom-iting, abdominal distention and inability to defecate, all of which are associated with the underlying intestinal obstruction. Persistent untreated SEP may advance to intestinal perforation, representing a life-threatening condition. However, preoperative diagnosis remains a particular clinical challenge, and most diagnoses are confirmed only when the typical fibrous membrane en-casing the small intestine is discovered by laparotomy. Here, we report the clinical presentation of an 87-year-old male with signs of intestinal obstruction and the ul-timate diagnosis of concurrent abdominal cocoon, rightincarcerated Meckel's diverticulum, and gastrointestinal perforation in laparotomy.     

Complicated Littre's umbilical hernia with normal Meckel's diverticulum: A case report and review of the literature

Introduction and importanceA Littre's hernia (LH) is defined by the presence of Meckel's diverticulum (MD) in any kind of hernia sac. Preoperative diagnosis of LH is a challenge because of its rarity and the absence of specific radiological findings and clinical presentation. Surgery is the appropriate treatment of complicated LH that is an extremely rare condition with approximately 50 cases reported in the literature over the past 300 years.Case presentationA 46-year-old Caucasian female was admitted to the Emergency Department with a two-day history of abdominal pain. Physical examination revealed an irreducible and painfull mass in umbilical region. Abdominal computed tomography scan showed the protrusion of greater omentum and small bowel loop through the umbilical ring. Laboratory tests were unremarkable. After diagnosis of strangulated umbilical hernia, the patient underwent exploratory laparotomy: the irreducible umbilical hernial sac was opened with presence of incarcerated and strangulated omentum and uncomplicated MD. Resection of incarcerated and ischemic greater omentum alone was performed. The postoperative course of patient was uneventful.Clinical discussionMeckel's diverticulum (MD) is a vestigial remnant of the omphalomesenteric duct, representing the most common congenital malformation of the gastrointestinal tract. Preoperative diagnosis of LH is very difficult and surgery represents the correct treatment of complicated LH.ConclusionLH represents an extremely rare complication of MD difficult to diagnose and suspect because of the lack of specific radiological findings and clinical presentation. Surgery represents the appropriate treatment of abdominal wall hernias and complicated MD.