A 3-year-old boy with a right-sided and painful inguinal swelling for the last 2 h was admitted to the emergency department. As there were no apparent peritoneal irritation findings, right-sided incarcerated inguinal hernia was reduced and the patient was scheduled for an elective herniorrhaphy. Perioperatively even though the sac seemed empty, it was opened in order to inspect its content. The adherence of Meckel's diverticulum (MD) to the base of hernial sac was realized and Littre hernia (LH) was diagnosed. The hernia was highly ligated after the wedge resection of the diverticulum and anastomosis. The patient was fed on the second postoperative day and discharged on the third postoperative day. Despite numerous presentations of LH in the adult age group in the literature, there are limited data about the disease in the childhood period. Even though the scarcity of the data, there are some so-called rules for LH in childhood like protruding more common through umbilical hernias, containing heterotopic tissues more frequent than adult age and incarcerating/strangulating more often. The aim of this study is to review the reported LH cases, present a new case and discuss the features of LH in childhood period.
A 2.5-month-old girl with a left-sided, painful inguinal swelling for the last 2 days was brought to the emergency department. After physical examination and radiological evaluation, the diagnosis of incarcerated inguinal hernia of the ovary was made. Because of the long-standing history, she was taken to the operation room without an attempt for manual reduction. Perioperatively, the torsion of the ovary with distal fallopian tube within the indirect hernia sac was seen. As untwisting of the ovary has resulted in no change in the color, oophorectomy before hernia repair was performed.The majority of the painful inguinal swellings in the infancy are related to incarcerated hernia. The treatment option varies from manual reduction to surgical intervention, depending on the duration from beginning of swelling to the time the exact diagnosis was made. Even though the presence of short-term history and the lack of peritoneal irritation findings are indications for a manual reduction, the suspicion of an ovarian torsion should be raised for ovaries within the incarcerated inguinal hernia, and ovarian viability should be considered before an attempt of manual reduction.
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