Velásquez-Bueso Andrés Eduardo, Sánchez-Sierra Luis Enrique, Villeda-Rodríguez Sergio David, Martínez-Quiroz Roberto Antonio
National Autonomous University of Honduras, Tegucigalpa, Honduras.
Honduran Institute of Social Security, Tegucigalpa, Honduras.
Case Rep Surg. 2019 Jun 10;2019:4217329. doi: 10.1155/2019/4217329. eCollection 2019.
Inguinal hernia is the most common condition in both male and female subjects. Amyand's hernia is characterized by the presence of the cecal appendix, swollen or not, inside the inguinal hernia sac. It is a rare condition and represents 1% of all the inguinal hernia pathology. Littre's hernia (LH) is a condition defined by the presence of a Meckel diverticulum (MD) inside a hernial sac. It is an extremely rare condition, with less than 50 cases reported in the last three hundred years, present in only 1% of all diagnosed MD.
A six-year-old male patient presented with a history of two bilateral protruding masses in the inguinal-scrotal region that have continued to grow since birth. No gastrointestinal symptoms were reported. Physical examination showed a bilateral inguinoscrotal mass which increased in size during the Valsalva maneuver. Surgical intervention was carried out with a bilateral hernia repair being performed under an anterior method, the surgical invagination of the MD within the small intestine and the appendix within the caecum.
Both entities should be considered as a differential diagnosis when it comes to a pediatric patient with unilateral or bilateral inguinal hernias with an uncertain etiology, allowing an early diagnosis and prompt treatment. We present here the first recorded case of both Amyand's hernia and Littre's hernia presenting simultaneously in a pediatric patient.
腹股沟疝是男性和女性中最常见的病症。艾米安德疝的特征是腹股沟疝囊内存在盲肠阑尾，无论其是否肿胀。这是一种罕见病症，占所有腹股沟疝病理的1%。利特尔疝（LH）是一种由疝囊内存在梅克尔憩室（MD）所定义的病症。这是一种极其罕见的病症，在过去三百年中报告的病例不到50例，仅占所有已诊断MD的1%。
一名六岁男性患者，有自出生以来双侧腹股沟 - 阴囊区域出现两个突出肿块且持续增大的病史。未报告有胃肠道症状。体格检查显示双侧腹股沟阴囊肿块，在瓦尔萨尔瓦动作时增大。进行了手术干预，采用前路方法进行双侧疝修补，将小肠内的MD和盲肠内的阑尾进行手术内翻。
对于病因不明的单侧或双侧腹股沟疝的儿科患者，这两种病症都应作为鉴别诊断考虑，以便早期诊断和及时治疗。我们在此展示了首例儿科患者同时出现艾米安德疝和利特尔疝的记录病例。
