Asian Journal of Case Reports in Surgery

Background: Littre's hernia, characterized by the presence of Meckel's diverticulum within the hernial sac, is an uncommon condition. The combination of an incarcerated Littre's hernia and perforation of Meckel's diverticulum is exceptionally rare, adding to the novelty and clinical interest of this case.

Case Presentation: We report the case of a 76-year-old female who presented with painful paraumbilical swelling and signs of inflammation. The patient, with a past medical history including diabetes, dyslipidemia, and hypertension, was initially diagnosed with an incarcerated paraumbilical Littre's hernia based on clinical examination and radiological findings. During open hernia repair, the hernial sac was found to contain omentum, ileum, and a perforated Meckel's diverticulum caused by a fish bone. The patient subsequently underwent a segmental bowel resection and primary repair of the hernial defect. She had an uneventful postoperative hospital course and was appropriately discharged.

Conclusion: This case report highlights a very rare and complicated presentation of Littre's hernia associated with a perforated Meckel's diverticulum, emphasizing the critical importance of clinical vigilance. Timely surgical intervention is essential for effectively managing such complex cases. This case underscores the need for increased awareness among healthcare professionals regarding potential complications of Littre's hernia. Further documentation and study of similar cases could significantly enhance our understanding of this condition and inform future treatment strategies, ultimately improving patient outcomes.