title: A rare case of a strangulated Littre's hernia with Meckel's diverticulum duplication. Case report and literature review.
abstract: BACKGROUND
  The Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract present in approximately 1-4% of the population; the MD duplication is exceedingly rare with only a few reports of it. Here we present the firs case of a strangulated Littre's hernia with MD duplication.
  
  
  METHODS
  A 30-year-old male presented to the emergency room with clinical signs of small bowel obstruction, at physical examination, a right incarcerated inguinal hernia with erythema was found. We did a laparotomy, and two MD were found, one in the sac with ischemia, and the other 90cm from the Bahuińs valve. A diverticulectomy of the ischemic diverticulum was done, and the other MD was left in place; the inguinal region was repaired with a Lichtenstein technique.
  
  
  CONCLUSIONS
  The complications of the MD are 3-4 times more frequent in men, been an intestinal obstruction, hemorrhage, diverticulitis, ulceration, and perforation. A Littrés hernia is when the MD is found in the sac; this is seen in the inguinal region in 50% of the cases. The management of a Littre's hernia is the resection of the MD; it could be done by an intestinal resection or by a diverticulectomy accordingly to the Park criteria.
  
  
  CONCLUSIONS
  As to our knowledge, this is the first case of an incarcerated Littre's hernia with duplication of a Meckel's diverticulum.
authors.affiliation: Division of Surgery, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Salvador Quevedo y Zubieta street #750, Guadalajara, Jalisco, Mexico. Electronic address: lopezlizarraga43@yahoo.com.
authors.forename: C R
authors.initials: CR
authors.lastname: López-Lizárraga
authors.affiliation: Department of Bariatric Surgery, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: M P
authors.initials: MP
authors.lastname: Sánchez-Muñoz
authors.affiliation: Department of Pathology, Hospital San Javier, Guadalajara, Jalisco, Mexico.
authors.forename: G E
authors.initials: GE
authors.lastname: Juárez-López
authors.affiliation: Department of Surgery, Hospital IMSS, 180 Guadalajara, Jalisco, Mexico.
authors.forename: L
authors.initials: L
authors.lastname: Pelayo-Orozco
authors.affiliation: Department of General Surgery, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico.
authors.forename: L F
authors.initials: LF
authors.lastname: De la Cerda-Trujillo
authors.affiliation: Department of General Surgery, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Mexico. Electronic address: plonecef@gmail.com.
authors.forename: C F
authors.initials: CF
authors.lastname: Ploneda-Valencia
keywords: Double Meckel’s diverticulum; Meckel’s diverticulum duplication; Strangulated Littre’s hernia