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Combined Littre and Richter’s femoral hernia: an extremely rare intra-operative finding

Clinical practice, 177 - 180
doi: 10.11138/gchir/2018.39.3.177
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Abstract
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Littre hernia is defined as the herniation of a Meckel’s diverticulum, while Richter’s hernia is the herniation of a portion of the bowel wall. An extremely rare case of a combined Littre and Richter’s femoral hernia is reported. An 82-year-old male presented at the emergency department with a painful golf ball-like mass at the right inguinofemoral region. With the diagnosis of incarcerated femoral hernia, he was urgently taken to the operating room. Intraoperatively, an incarcerated Littre, as well as a Richter’s hernia were revealed. Enterectomy and side-to-side small bowel anastomosis were performed. The patient made an uneventful recovery. To the best of our knowledge, the present is the first report of a combined Littre and Richter’s femoral hernia.
Such findings should be reported to raise the awareness of surgeons for complicated cases. It is of utmost importance to have a high suspicion index for strangulated hernias, to minimize the time between admission and surgery.

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