A Case of Femoral Hernia with Incarcerated Meckel’s Diverticulum

Abstract

A 70-year-old female patient visited us with a 2-day history of a painful mass felt in the right inguinal region. Examination revealed a tender, palpable tender mass measuring 4 cm in diameter. Multidetector-row CT showed a mass herniating through the saphenous opening on the internal aspect of the right femoral vein. No signs of bowel obstruction were noted, and we diagnosed a right femoral hernia with incarceration of a segment of the small intestine. Emergency surgery revealed the hernia contents as a small intestinal diverticulum measuring 4 cm long, which had turned dark red as a result of obstruction in the femoral canal. We performed resection of diverticulum, and repaired the femoral hernia by the McVay’s method. The resected small intestinal diverticulum was determined as being Meckel’s diverticulum, because it had its own mesentery and was diagnosed as a true diverticulum by histopathological examination. Regardless of the site of herniation, a hernia that contains Meckel’s diverticulum is termed as Littré’s hernia. A femoral hernia involving Meckel’s diverticulum is rare. In this case, diagnosis was delayed and intestinal necrosis was imminent. It is important to always bear in mind the possibility of rare hernias, such as in this case.