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    ABSTRACT: Meckel's diverticulum is a very common congenital anomaly of the gastrointestinal tract but many cases remain asymptomatic and are diagnosed incidentally during laparoscopic or other surgical procedures. Cases of femoral hernia involving Meckel's diverticulum are rare, with less than 50 cases reported in the literature since Littre published the first description of this coincident condition over 300 years ago. While all true "Littre's hernias" contain a Meckel's diverticulum, the involved anatomical sites are various, the most common being the inner groin (inguinal), the outer groin (femoral), and the belly button (umbilical). Complications of Littre's hernias include incarceration, strangulation, necrosis, and perforation. Herein, we describe a case of Littre's hernia that involved an incarcerated Meckel's diverticulum in a femoral hernia that was diagnosed upon investigation of symptomology manifesting from perforation and was successfully managed by surgical resection with stapler devices.
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    ABSTRACT: Obturator hernia is an extremely rare type of hernia with an incidence of less than 1% of all abdominal wall hernias occurring predominantly in elderly females characterized by protrusion of the intra-abdominal viscera into the obturator foramen. It presents with pain along the medial aspect of the thigh referred to the knee due to compressed obturator nerve and sometimes as an uncommon cause of intestinal obstruction. It remains a clinical diagnostic dilemma and often perplexing the decision for surgery. This explanatory review emphasizes and illuminates its various facets under the rationale of its diagnosis and management to familiarize surgeons with the condition. The data for the present review was obtained by searching in PubMed and other databases using key terms "obturator hernia", "abdominal hernia", "intestinal obstruction", and "Howship-Romberg sign". Many original articles, reviews, and case reports were selected. Since it is very rare that a mass can be found on inspection of the medial aspect of the thigh and the clinical signs are not always present, hence obturator hernia is a condition which leads to both difficult and delayed clinical diagnosis and consequently having a significant morbidity and mortality rates, especially in the elderly. Obturator hernia should always be in the differential diagnosis in septuagenarian to nonagenarian patients with nonspecific signs and symptoms of intestinal obstruction. Computed tomography of abdomen and pelvis has been found to be the gold standard for preoperative diagnosis and this condition necessitates immediate surgical reduction and repair of the defect either by open or laparoscopic approach.
    International Journal of Colorectal Disease 08/2011; 27(2):133-41. DOI:10.1007/s00384-011-1289-2 · 2.24 Impact Factor

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Jun 6, 2014