Management of Littre Hernia—Case Report and Systematic Review of Case Reports
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Published:2023-05-29
Issue:11
Volume:12
Page:3743
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ISSN:2077-0383
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Container-title:Journal of Clinical Medicine
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language:en
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Short-container-title:JCM
Author:
Răcăreanu Marian1, Preda Silviu Daniel1ORCID, Preda Agnesa2, Strâmbu Victor Dan Eugen3, Radu Petru Adrian3ORCID, Bratiloveanu Tudor Constantin12, Pătrașcu Ștefan12ORCID, Marinescu Daniela12, Sapalidis Konstantinos14ORCID, Șurlin Valeriu12ORCID
Affiliation:
1. Faculty of Medicine, Department of Surgical Specialities, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania 2. Craiova Emergency Clinical Hospital, 210218 Craiova, Romania 3. Clinic of Surgery of “Dr. Carol Davila” Nephrology Clinical Hospital, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania 4. Third Surgery Clinic, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
Abstract
Littre hernia is a rare type of hernia in which a Meckel diverticulum is found in the hernia sac. Given the rare nature of this disease, little data on demographics and surgical management exists. In this article, we provide a case report of a strangulated inguinal Littre hernia and perform a systematic review of the literature. The PubMed database was searched on 5 March 2022, and all cases of Littre hernia in adults that had English abstracts or full-text were analyzed. Our primary objective was to evaluate the surgical management and outcomes of this particular type of hernia, and our secondary objectives were to assess demographic characteristics, presentation particularities, and recurrence rates. We identified 89 articles with 98 cases, including our own. Results show a high prevalence of complications described intraoperatively, with strangulation being present in up to 38.46% of patients. The laparoscopic approach was utilized in patients with femoral, inguinal, and umbilical hernias. The most commonly performed type of resection was MD resection, followed by bowel resection, while a minority of cases (5.48%) remained unresected. Mesh repair was more frequently performed in patients with MD resection. A mortality rate of 8.7% in patients who underwent bowel resection was found. A relatively high number of reports of ectopic tissue (21.21%), ulceration (12.12%), and tumors (9.09%) were found. The average follow-up was 19.5 ± 10.29 months, with no hernia recurrence. In conclusion, most cases are admitted in an emergency setting, and intestinal obstruction is frequently associated. A minimally invasive approach can be an option even for complicated hernias. MD resection or bowel resection is usually employed, depending on the extent of ischemic lesions. Patients undergoing bowel resection may be prone to worse outcomes.
Funder
University of Medicine and Pharmacy of Craiova, Romania
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