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April 11, 1977

Littre Hernia

JAMA. 1977;237(15):1599. doi:10.1001/jama.1977.03270420067021

FAILURE of the vitelline sac to close (usually during the seventh week of embryonic life) leads to the formation of the Meckel diverticulum. This is usually located 30 to 90 cm from the ileocecal valve at the antimesenteric border, but it can occur anywhere else in the intestinal tract. In 1719 Alexis Littre described a hernia bearing his name; at present, two kinds are recognized: combined Littre hernia (a Meckel diverticulum accompanied by any other viscus in the hernia sac) and true Littre hernia (a solitary Meckel diverticulum).1,2 Of these hernias, 50% will present through the inguinal orifice, and 30% at the umbilicus3; up to 1972, just 38 cases of strangulated Meckel diverticulum in a femoral hernia had been reported.4

Symptoms of Littre hernia consist of vague, crampy abdominal pain, dyspepsia, and occasional anorexia with malaise. The bowels usually move normally or with a tendency to be