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

Hernia. 2017 Dec;21(6):901-904. doi: 10.1007/s10029-017-1670-3. Epub 2017 Oct 3.

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.

Keywords: Conservative therapy; Inguinal hernia; Round ligament; Ultrasonography; Varicosities.

MeSH terms

  • Adult
  • Conservative Treatment
  • Diagnostic Errors*
  • Female
  • Hernia, Inguinal / diagnosis*
  • Humans
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis*
  • Pregnancy Complications, Cardiovascular / therapy
  • Retrospective Studies
  • Round Ligament of Uterus / blood supply*
  • Ultrasonography, Doppler, Color
  • Varicose Veins / diagnosis*
  • Varicose Veins / therapy