Background: Meckel’s diverticulum (MD), a true diverticulum with all 3 layers, is the most common congenital anomaly of the gastrointestinal tract is due to the failure of the obliteration of the vitellointestinal duct during the 5th to 9th week of gestation life. MD can present as haemorrhage, obstruction, diverticulitis, intussusceptions or perforation. Here we present a case of strangulated Littre’s hernia in the right inguinal region.

 

Case report: A 19-year-old male presented with a right groin swelling of 1-month duration. His swelling was not reducible for the past 1 day. He had associated vomiting of 1-day duration. On examination he was febrile and with a heart rate of 96 per minute. His groin examination revealed a 6 x 4 cm swelling which was tense and tender with absent cough impulse. His Chest X-ray and abdomen were within normal limit. His blood investigation was within normal limits except for a leucocytosis. A provisional diagnosis of strangulated inguinal hernia was made and patient was taken up for surgery. A right inguino-scrotal incision was made. The hernia sac was opened at the fundus. 5ml of toxic fluid was let out. The content was a gangrenous Meckel’s Diverticulum which was 8cm in length and about 60 cm from ileocaecal junction. Resection of the gangrenous MD was done with end- o-end anastomosis of the ileum. Postoperative period was uneventful and he was discharged on the 9th post-operative day.

 

Conclusion: Meckel’s Diverticulum is one of the rare contents of the hernial sac. Diagnosis is usually intraoperative. Management includes resection of the diverticulum.