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Published in: Hernia 6/2017

01-12-2017 | Original Article

Forty-one cases of round ligament varicosities that are easily misdiagnosed as inguinal hernias

Authors: H. Yonggang, Y. Jing, W. Ping, G. Guodong, M. Chenxia, X. Xiaojing, Z. Fangjie, W. Hao

Published in: Hernia | Issue 6/2017

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Abstract

Purpose

To demonstrate the benefit and safety of conservative therapy for round ligament varicosities (RLVs) that are easily misdiagnosed as inguinal hernias.

Methods

We retrospectively analyzed clinical materials of 41 consecutive cases of RLVs diagnosed by ultrasound in a single hospital from January 2011 to December 2015. Misdiagnosis rate, clinical and sonographic features, management after diagnosis and prognosis were recorded.

Results

All forty-one cases were pregnant females in their second or third trimester. Twenty-eight cases were first misdiagnosed as inguinal hernias (68.3%). Thirty cases presented as reducible swelling in the inguinal area (73.2%), and twenty-five of which were painful (61.0%). Four cases only felt pain in the inguinal area without swelling (9.7%). Seven cases had no obvious discomfort (17.1%). All cases were diagnosed as RLVs by gray-scale and color Doppler ultrasonography and justified a wait-and-see strategy. Thirty-seven cases were followed until total recovery after delivery (follow-up rate 90.2%). Swelling with or without pain disappeared spontaneously postpartum.

Conclusions

RLVs are easily misdiagnosed as inguinal hernias and color Doppler of the inguinal area is the best examination for making the correct diagnosis. Conservative therapy for RLV is beneficial and safe when assured by color Doppler.
Literature
1.
go back to reference Ryu KH, Yoon JH (2014) Ultrasonographic diagnosis of round ligament varicosities mimiking inguinal hernia: report of two cases with literature review. Ultrasonography 33(3):216–221CrossRefPubMedPubMedCentral Ryu KH, Yoon JH (2014) Ultrasonographic diagnosis of round ligament varicosities mimiking inguinal hernia: report of two cases with literature review. Ultrasonography 33(3):216–221CrossRefPubMedPubMedCentral
2.
go back to reference Lechner M, Fortelny R, Ofner D, Mayer F (2014) Suspected inguinal hernias in pregnancy—handle with care! Hernia 18(3):375–379CrossRefPubMed Lechner M, Fortelny R, Ofner D, Mayer F (2014) Suspected inguinal hernias in pregnancy—handle with care! Hernia 18(3):375–379CrossRefPubMed
3.
go back to reference Uzun M, Akkan K, Coskun B (2010) Round ligament varicosities mimicking inguinal hernias in pregnancy: importance of color Doppler sonography. Diagn Interv Radiol 16:150–152PubMed Uzun M, Akkan K, Coskun B (2010) Round ligament varicosities mimicking inguinal hernias in pregnancy: importance of color Doppler sonography. Diagn Interv Radiol 16:150–152PubMed
4.
go back to reference McKenna DA, Carter JT, Poder L et al (2008) Round ligament varices: sonographic appearance in pregnancy. Ultrasound Obstet Gynecol 31(3):335–357CrossRef McKenna DA, Carter JT, Poder L et al (2008) Round ligament varices: sonographic appearance in pregnancy. Ultrasound Obstet Gynecol 31(3):335–357CrossRef
5.
go back to reference Attah AA, Huston JM (1991) The anatomy of the female gubernaculum is different from the male. Aust N Z J Surg 61(5):380–384CrossRefPubMed Attah AA, Huston JM (1991) The anatomy of the female gubernaculum is different from the male. Aust N Z J Surg 61(5):380–384CrossRefPubMed
6.
go back to reference Ando H, Kaneko K, Ito F et al (1997) Anatomy of the round ligament in female infants and children with an inguinal hernia. Br J Surg 84(3):404–405CrossRefPubMed Ando H, Kaneko K, Ito F et al (1997) Anatomy of the round ligament in female infants and children with an inguinal hernia. Br J Surg 84(3):404–405CrossRefPubMed
7.
go back to reference Polat AV, Aydin R, Polat AK et al (2013) Round ligament varicosities a rare cause of groin swelling in pregnancy. Abdom Imaging 38(5):1178–1181CrossRefPubMed Polat AV, Aydin R, Polat AK et al (2013) Round ligament varicosities a rare cause of groin swelling in pregnancy. Abdom Imaging 38(5):1178–1181CrossRefPubMed
8.
go back to reference Ijpma FF, Boddeus KM, de Haan HH, Van Geldere D (2009) Bilateral round ligament varicosities mimicking inguinal hernia during pregnancy. Hernia 13:85–88CrossRefPubMed Ijpma FF, Boddeus KM, de Haan HH, Van Geldere D (2009) Bilateral round ligament varicosities mimicking inguinal hernia during pregnancy. Hernia 13:85–88CrossRefPubMed
10.
11.
go back to reference Bulbul E, Taskin MI, Yanik B et al (2015) Rare cause of bilateral groin swelling: round ligament varicosities. Pak J Med Sci 31(4):1012–1014PubMedPubMedCentral Bulbul E, Taskin MI, Yanik B et al (2015) Rare cause of bilateral groin swelling: round ligament varicosities. Pak J Med Sci 31(4):1012–1014PubMedPubMedCentral
12.
go back to reference Borrero E, Weil PH, Cooper JJ (1983) Hemorrhage into the round ligament. JAMA 249(24):3006CrossRef Borrero E, Weil PH, Cooper JJ (1983) Hemorrhage into the round ligament. JAMA 249(24):3006CrossRef
13.
go back to reference Georgakopoulos PA (1979) Perinatal rupture of genital varicosities. Int Surg 64:74–75 Georgakopoulos PA (1979) Perinatal rupture of genital varicosities. Int Surg 64:74–75
Metadata
Title
Forty-one cases of round ligament varicosities that are easily misdiagnosed as inguinal hernias
Authors
H. Yonggang
Y. Jing
W. Ping
G. Guodong
M. Chenxia
X. Xiaojing
Z. Fangjie
W. Hao
Publication date
01-12-2017
Publisher
Springer Paris
Published in
Hernia / Issue 6/2017
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-017-1670-3

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