{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T13:49:19Z","timestamp":1782481759432,"version":"3.54.5"},"reference-count":22,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,9]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>A hernia containing a Meckel\u2019s diverticulum is termed a Littre hernia, with the mixed subtype describing the presence of additional abdominal viscera. Mixed Littre hernias are rare and often identified intra-operatively. We report the case of a man in his 60s undergoing a right inguinoscrotal hernia repair who was found to have a 10\u2009cm Meckel\u2019s diverticulum with a loop of ileum within the hernia sac. The diverticulum appeared normal and was managed non-operatively with no complications at 6\u2009months. Management of an incidental Meckel\u2019s diverticulum remains controversial, divided between non-operative and operative management which can include selective or routine prophylactic resection. High-quality evidence is limited, and existing studies focus on intra-abdominal Meckel\u2019s diverticula rather than those within a hernia sac which may have a distinct risk profile. Further research and development of guidelines are required to guide intra-operative decision making in rare cases such as a mixed Littre hernia.<\/jats:p>","DOI":"10.1136\/bcr-2025-271825","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T13:10:44Z","timestamp":1782479444000},"page":"e271825","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management of a mixed Littre hernia"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6160-2038","authenticated-orcid":false,"given":"Clare","family":"Bartholomew","sequence":"first","affiliation":[{"name":"General Surgery, University Hospitals Sussex NHS Foundation Trust, Chichester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Sutton","sequence":"additional","affiliation":[{"name":"General Surgery, University Hospitals Sussex NHS Foundation Trust, Chichester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"2026062606101034000_19.6.e271825.1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.5152\/tjg.2018.18228","article-title":"Littre hernia in children: A clinical aspect","volume":"30","author":"Bakal","year":"2019","journal-title":"Turk J Gastroenterol"},{"key":"2026062606101034000_19.6.e271825.2","unstructured":"Sadler TW . Langman\u2019s medical embryology. 12th edn. Philadelphia: Wolters Kluwer, 2012:225\u20136."},{"key":"2026062606101034000_19.6.e271825.3","doi-asserted-by":"crossref","first-page":"726","DOI":"10.17235\/reed.2018.5628\/2018","article-title":"Meckel\u2019s diverticulum: clinical features, diagnosis and management","volume":"110","author":"Kuru","year":"2018","journal-title":"Rev Esp Enferm Dig"},{"key":"2026062606101034000_19.6.e271825.4","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000012154","article-title":"Systematic review of epidemiology, presentation, and management of Meckel\u2019s diverticulum in the 21st century","volume":"97","author":"Hansen","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"2026062606101034000_19.6.e271825.5","doi-asserted-by":"publisher","DOI":"10.1007\/BF00295917"},{"key":"2026062606101034000_19.6.e271825.6","first-page":"D11","article-title":"Meckel\u2019s Diverticulum Enterolith: An Extremely Rare Cause of Intestinal Obstruction","volume":"11","author":"Symeonidis","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"2026062606101034000_19.6.e271825.7","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.amsu.2019.05.017","article-title":"Malignant neoplasms of Meckel\u2019s diverticulum; an evidence based review","volume":"43","author":"Kabir","year":"2019","journal-title":"Ann Med Surg (Lond)"},{"key":"2026062606101034000_19.6.e271825.8","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjac617","article-title":"Littre\u2019s hernia-a reason for resection","volume":"2023","author":"Seok","year":"2023","journal-title":"J Surg Case Rep"},{"key":"2026062606101034000_19.6.e271825.9","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/000313480607200309","article-title":"Littre Hernia: Surgical Anatomy, Embryology, and Technique of Repair","volume":"72","author":"Skandalakis","year":"2006","journal-title":"The American Surgeon"},{"key":"2026062606101034000_19.6.e271825.10","article-title":"Littre\u2019s Umbilical Hernia in a Child: A Case Report and Scoping Review","volume":"16","author":"Zeng","year":"2024","journal-title":"Cureus"},{"key":"2026062606101034000_19.6.e271825.11","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s10029-018-1867-0","article-title":"Littre\u2019s hernia: a systematic review of the literature","volume":"23","author":"Schizas","year":"2019","journal-title":"Hernia"},{"key":"2026062606101034000_19.6.e271825.12","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2021.106126","article-title":"Complicated Littre\u2019s umbilical hernia with normal Meckel\u2019s diverticulum: A case report and review of the literature","volume":"84","author":"Evola","year":"2021","journal-title":"Int J Surg Case Rep"},{"key":"2026062606101034000_19.6.e271825.13","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi","year":"2023","journal-title":"Int J Surg"},{"key":"2026062606101034000_19.6.e271825.14","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(76)90043-X"},{"key":"2026062606101034000_19.6.e271825.15","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31815aaaf8"},{"key":"2026062606101034000_19.6.e271825.16","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000154270.14308.5f"},{"key":"2026062606101034000_19.6.e271825.17","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1097\/00000658-199410000-00014","article-title":"Surgical management of Meckel\u2019s diverticulum. 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