Meckel's Diverticulum Report

Meckel’s diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract associated with many diverse and unusual complications has an incidence of 2- 3% (1) . Meckel’s Diverticulum is a true diverticulum comprising all intestinal layers. It is usually an incidental finding. Strangulation of Meckel’s diverticulum (Littre’s Hernia) is a rare anatomo -clinical form. Surgery is the mainstay of treatment. We report a very rare case of Littre hernia which is a complication of Meckel 's diverticulum and presented with an irreducible mass in right inguinal site

KEY WORDS Littre's inguinal hernia ,Meckel’s diverticulum , Ectopic gastric mucosa , irreducible , peptic ulceration .

INTRODUCTION Littre’s Hernia is an

Since then hernia sacs containing only Meckel’s diverticulum have been called Littre’s hernia.1-3 Johann Friedrich Meckel (1781-1833) described diverticula of the distal ileum in 1812 and defined about the congenital origin .1-4,6

50% of the Meckel’s diverticula are in inguinal hernias, 20% in femoral, 20% in umbilical and remaining 10% in other miscellaneous hernias . complications of Meckel’s diverticula are Haemorrhage ,Obstruction , Diverticulitis ,Umbilico-enteric fistula ,Perforation ,Intussusception , Foreign bodies , Neoplasia-benign or malignant , Peptic ulceration ,Littre’s hernia .

The diagnosis of a strangulated Littre’s Hernia is to be made preoperatively as the presenting signs and symptoms are more subtle and appear slowly unlike strangulated small intestine 6, 7, 9. The most useful method of detection of a Meckel diverticulum is Technetium-99m scanning. It is a method depends on ulceration and bleeding because to the heterotropic gastric mucosa (8) . The symptoms and signs of intestinal obstruction occur late. Obstruction can occur only if the base of the diverticulum is broad enough to cause narrowing of the intestinal lumen. A mass at the hernial site which is tender associated with nausea, vomiting and abdominal pain are the main symptoms. The swelling over the hernia site may be small at first, and may be missed as the cause of