Littré's hernia (LH) is a rare clinical entity defined by the presence of Meckel's diverticulum (MD) within a hernial sac. Although MD is the most common congenital abnormality of the intestinal tract, most of its cases remain asymptomatic. It may, however, manifest itself in the form of multiple complications. One of its rare complications is LH, which is reported occurring in a mere 1% of all MD cases. The anamneses of LH are like any other hernia containing the gut, making its preoperative diagnosis unlikely. We present herein a case of a 16-year-old boy with an incarcerated LH at the inguinal region, which was successfully treated by wedge resection of the diverticulum followed by hernia repair.

Inferior vena cava (IVC) is the most commonly injured abdominal vessel in blunt and penetrating abdominal traumas, and its injury carries a very high rate of mortality. Hemodynamic instability at presentation, poor response to resuscitation, the anatomical level of venacaval injury, low Glasgow Coma Score, and concomitant vascular and visceral injuries are the main factors predicting the outcome of the patient. The primary surgical intervention needed is the control of hemorrhage followed by the repair of IVC defect, which may be done by venorrhaphy, ligation, use of patch or grafts, and other complicated procedures. Each of these techniques carries its own merits and demerits. This case report is of a patient who survived an infrarenal tear of IVC caused by a firearm injury that was repaired by venorrhaphy at a hospital of Pakistan with limited cardiac and endovascular facilities.

Introduction Urinary lithiasis is usually managed by extracorporeal shock wave lithotripsy (ESWL). Patients are examined using non-contrast computed tomography (NCCT) in order to evaluate the feasibility of ESWL, according to where the stone is located and how big is its size. The objective of this study is to determine the outcomes of ESWL in patients having high-density renal stone, evaluated using NCCT. Materials and methods A descriptive case series study was conducted in the Department of Urology, Sindh Institute of Urology & Transplantation, Karachi for six months. Patients of either gender aged between 25-50 years, who presented with solitary renal and ureteric calculi of 0.5-2 cm in diameter and high-density renal stones [>750 hounsfield units (HU)] were enrolled. ESWL was performed and a satisfactory outcome was defined as complete stone clearance in less than or equal to three ESWL sessions. Statistical Package for Social Sciences (SPSS) (IBM Corp., Armonk, NY) was used to analyze frequencies and percentages of the number of ESWL sessions, complete renal stone clearances, and satisfactory outcomes at the end of 12 weeks. A p-value of <0.05 was considered significant. Results The mean age of the patient was reported to be 34.08 ± 9.53 years. 51.6% male preponderance was noticed. Renal and ureteric stones were found in 69.7% and 30.3% of patients, respectively. 21.3% of patients showed stone clearance after two ESWL sessions, 27% of patients after three ESWL sessions, and 51.6% of patients after four ESWL sessions. Stone clearance was found in 58.2% of patients and a satisfactory outcome was found in 42.6% of patients. Conclusions Our results signify a satisfactory outcome of extracorporeal shock wave lithotripsy for high-density renal stone on non-contrast computed tomography. Further studies on a larger scale are needed to validate these results.