Meckel’s diverticulitis presenting with early abcess formation in femoral region: A clue for determining content of femoral hernia

Year 2015, Volume: 32 Issue: 3, 129 - 131, 17.11.2015

Kadir Yıldırım Recep Aktımur Gultekin Kucuk Suleyman Cetınkumar Nuraydın Ozlem

Abstract

Perforated Meckel’s diverticulitis (PMD) in a femoral hernia (FH) sac is a very rare clinical presentation. To determine the presence of such a complicated Littre’s hernia is challenging. To emphazise the clinical importance of groin abscess and consider the possibility of extreme diagnosis in these patients, clinical suspection is necessary. Here we present a male patient with a history of pain and tender mass in right inguinal region, which was seems like a groin abcess. However, intraoperative finding was a strangulated Meckel’s diverticulum in FH, the clinical appearance of entire bowel and pathological assessment were consistent with PMD. It’s noteworthy that, not only a drainage, but rapid intervention should be considered in all inguinal abcess with confusing physical examination and signs.

Keywords

Femoral hernia, Littre’s hernia, Meckel’s diverticulum, Perforation

References

• Bennett, L.C., Kahler, J.E., 1947. Generalized peritonitis due to perforation of a Meckel’s diverticulum incarcerated in a right femoral hernia. Calif. Med. 66, 139-141.
• Dahlstrand, U., Wollert, S., Nordin, P., Sandblom, G., Gunnarsson, U., 2009. Emergency femoral hernia repair: A study based on a national register. Ann. Surg. 249, 672-676. doi: 10.1097/SLA.0b013e31819ed943.
• McVay, C.B., Anson, B.J., 1949. Inguinal and femoral hernioplasty. Surg. Gynecol. Obstet. 88, 473-485.
• Mifsud, M., Ellul, E., 2011. Meckel’s diverticulum in a strangulated femoral hernia. Case report and review of literature. Ann. Ital. Chir. 82, 305-307.
• Mirza, M.S., 2007. Incarcerated Littre’s femoral hernia: Case report and review of the literature. J. Ayub. Med. Coll. Abbottabad. 19, 60-61.
• Sagar, J., Kumar, V., Shah, D.K., 2006. Meckel’s diverticulum: A systematic review. J. R. Soc. Med. 99, 501-505.
• Salkade, P.R., Chung, A.Y., Law, Y.M., 2012. De Garengeot’s hernia: An unusual right groin mass due to acute appendicitis in an incarcerated femoral hernia. Hong. Kong. Med. J. 18, 442-445.
• Weinstein, B.M., 1938. Strangulated Littre’s femoral hernia with spontaneous fecal fistula: Case report with a review of the literature. Ann. Surg. 108, 1076-1082.
• Zacharakis, E., Papadopoulos, V., Athanasiou, T., Ziprin, P., Zacharakis, E., 2008. An unusual presentation of Meckel diverticulum as strangulated femoral hernia. South. Med. J. 101, 96-98. doi: 10.1097/SMJ.0b013e31815d3c83.