Round ligament varices in pregnancy mimicking inguinal hernia: an ultrasound diagnosis

Abstract

A case of uncomplicated round ligament varices mimicking an irreducible inguinal hernia in the third trimester of pregnancy is presented. The clinical and ultrasound features, pathophysiology and the role of conservative management are discussed. Non-surgical treatment led to spontaneous regression after delivery.

A soft tissue groin mass

“…In this case the history of sudden onset in the third trimester of pregnancy suggested the diagnosis, but the correct diagnosis was confirmed by the typical appearances on Doppler ultrasound [6]. Many of the other possible diagnoses, such as lymphadenopathy, hernias, cysts and abscess, also have characteristic ultrasound appearances, while the absence of a solid component to the mass would make soft tissue tumour unlikely.…”

Bilateral round ligament varicosities mimicking an inguinal hernia in pregnancy: Case report

“…Similar to inguinal hernias, RLV can transmit cough impulses because increased abdominal pressure will lead to vein distension. 6,7 The coexistence of vulvar or lower limb varicosities might be a clue to the diagnosis of RLV. 6,7 In our case, there was no varicosity anywhere else.…”

Round ligament varicosities mimicking inguinal hernias in pregnancy: importance of color Doppler sonography

“…Both round ligament varicosities and inguinal hernias can occur in the second trimester of pregnancy (1,5). Pelvic vein enlargement typically occurs during this time, which can sometimes extend to the round ligament in the inguinal canal, resulting in round ligament varicosities.…”

“…In contrast, RLV should be managed conservatively, with the expectation that they will resolve spontaneously during the postpartum period (7). However, RLV require close observation during pregnancy because rupture of the varices, and acute variceal thromboses have been reported (1,5). If pain is the predominant symptom, thrombosis or rupture of RLV should be excluded (8).…”