[Round ligament varicosities mimicking inguinal hernia during pregnancy].

VU Medisch Centrum, afd. Chirurgie, Amsterdam, The Netherlands.
Nederlands tijdschrift voor geneeskunde 02/2009; 153:A169. DOI: 10.1016/j.jamcollsurg.2008.11.003
Source: PubMed

ABSTRACT 3 pregnant women, aged 34, 28, and 39 years respectively, presented with an inguinal swelling. In one patient the swelling was bilateral and painful. Reposition was possible and ultrasound examination revealed round ligament varicosities, the most common cause of an inguinal swelling during pregnancy. Expectative treatment is advised as the condition usually disappears after parturition. It is concluded that in every pregnant woman with an inguinal swelling, sonography with doppler imaging must be performed to confirm the diagnosis of round ligament varicosities to avoid unnecessary surgery.

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    ABSTRACT: PURPOSE: With a newly described diagnostic pathway, we aim to avoid unnecessary surgical exploration for suspected symptomatic groin hernias in pregnancy. METHODS: A consecutive series of eighteen pregnant women was referred to our department due to a gradual onset of inguinal swelling and groin ache. In a prospective clinical study, we evaluated these patients clinically and employed grey-scale and colour Doppler sonography (CDS) in all cases-following a newly described pathway. All patients were examined pre- and post-partum by two qualified surgeons. Median follow-up time was 11 months. RESULTS: 4/18 of the suspected hernias first occurred towards the end of the first, the majority (12/18) in the second, 2/18 in the last trimester and all were suspected after clinical examination only. Most women were referred by their gynaecologists. We found no hernias in any of the women but always noted large varicose veins along the round ligament during CDS. All women gave uncomplicated birth to single children, one by caesarean section. Complaints subsided spontaneously within roughly 2 weeks after delivery. No patient developed a groin hernia until the end of the follow-up period. CONCLUSION: The diagnosis of an inguinal hernia with a first symptomatic onset during pregnancy may be wrong in most cases. Anamnesis and clinical examination must be backed by CDS and round ligament varicosity as an important differential diagnosis must always be considered. Our structured diagnostic pathway helps to easily make the correct diagnosis. Surgical exploration of the groin during pregnancy must be avoided.
    Hernia 04/2013; · 1.69 Impact Factor
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    ABSTRACT: Round ligament varicosities during pregnancy are rare, and can easily be mistaken for an inguinal hernia. On physical examination, round ligament varicosities and groin hernia are difficult to distinguish. The diagnosis of round ligament varicosities can be established on gray-scale and color Doppler sonography. We experienced a case of round ligament varicosities in which a 29-year-old woman presented symptoms at 36 weeks gestation. The patient was diagnosed using Doppler sonography, managed with conservative therapy, and had an uncomplicated vaginal delivery at 40 weeks. The symptoms were resolved completely by two weeks postpartum. We report a case of round ligament varicosities that was diagnosed at 36 weeks of gestation with a review of the literature.
    Journal of the Korean Surgical Society. 06/2011; 80(6):437-9.