# Strangulated Littre's direct inguinal hernia: a case report and literature review

## TL;DR

A rare case of a strangulated Littre's hernia in a 66-year-old man highlights the importance of considering this condition in older patients.

## Contribution

This case report adds to the literature on Littre's hernia in elderly patients without gastrointestinal symptoms.

## Key findings

- A 66-year-old man presented with an incarcerated inguinal hernia containing a strangulated Meckel's diverticulum.
- The patient recovered uneventfully after surgical repair of the hernia.
- The case emphasizes the need for surgeons to consider Littre's hernia in older patients.

## Abstract

The rare occurrence of a Meckel's diverticulum within a hernial sac, known as a Littre’s hernia, was first described by the French anatomist and surgeon Alexis Littré in the 18th century. This condition is observed in only 0.09% of strangulated hernias. Patients typically present with an irreducible lump in the groin. In this case report, we present a 66-year-old man who sought medical attention with a 72-hour history of an incarcerated inguinal hernia. Patient underwent hernia repair and intraoperatively, strangulated Meckel's diverticulum, adhered medially to the base of the sac, was identified. The patient was discharged after an uneventful recovery. This case underlines the importance for surgeons to consider Littre's hernia as a potential differential diagnosis, even in patients over 60 years old who present without overt gastrointestinal symptoms. Maintaining a high index of suspicion for this rare type of hernia can help guide appropriate diagnostic evaluation and management.