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Int J Surg Case Rep. 2017;36:122-125. doi: 10.1016/j.ijscr.2017.05.006. Epub 2017 May 15.

Round ligament varicosities diagnosed as inguinal hernia during pregnancy: A case report and series from two regional hospitals in Japan.

Author information

1
Department of General Surgery, National Hospital Organization Saga National Hospital, 1-20-1, Hinode, Saga, 849-8577, Japan; Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan. Electronic address: dionysos917@hotmail.co.jp.
2
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan. Electronic address: sueguchi@nagasaki-u.ac.jp.
3
Department of General Surgery, National Hospital Organization Saga National Hospital, 1-20-1, Hinode, Saga, 849-8577, Japan. Electronic address: enjouji@saga-nh.hosp.go.jp.
4
Department of General Surgery, National Hospital Organization Saga National Hospital, 1-20-1, Hinode, Saga, 849-8577, Japan. Electronic address: fukuda@saga-nh.hosp.go.jp.
5
Department of General Surgery, National Hospital Organization Saga National Hospital, 1-20-1, Hinode, Saga, 849-8577, Japan. Electronic address: yamaguchi-j@saga-nh.hosp.go.jp.
6
Department of General Surgery, National Hospital Organization Saga National Hospital, 1-20-1, Hinode, Saga, 849-8577, Japan. Electronic address: inoue17@live.jp.
7
Department of General Surgery, National Hospital Organization Saga National Hospital, 1-20-1, Hinode, Saga, 849-8577, Japan. Electronic address: ffujita@nagasaki-u.ac.jp.
8
Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan. Electronic address: syspq904@yahoo.co.jp.
9
Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan. Electronic address: bunbuku@nagasaki-u.ac.jp.

Abstract

INTRODUCTION:

Round ligament varicosities (RLV) are not well-known and they are usually caused by pregnancy. Although the groin swelling of RLV mimics an inguinal hernia, it is difficult to distinguish between them through clinical examination alone, and there have been few published reports on this topic, especially from Asia.

CASE PRESENTATION:

A 37-year-old Japanese woman complained of left groin swelling for 2 weeks at her 28th week of gestation of her first pregnancy. According to a physical examination, she had a soft, painless swelling in the superficial inguinal ring of the left groin. An inguinal hernia was suspected and she was thus scheduled to undergo herniorrhaphy. However, since she had varicosities in the left labia majora, she first underwent color Doppler ultrasonography and a final diagnosis of round ligament varicosities was this made. Her symptoms resolved after delivery of her baby.

DISCUSSION:

We herein report 10 cases of RLV in pregnant Japanese women who were initially suspected of having an inguinal hernia. All of them were suspected to suffer from inguinal hernias after a clinical examination by their attending gynecologist. All of them were diagnosed using gray scale and color Doppler ultrasonography, treated with conservative management, and the symptoms resolved in all cases after the delivery.

CONCLUSION:

This is the largest report from Asia regarding RLV. To avoid unnecessary surgery in pregnant women, surgeons must be aware of this entity make an accurate diagnosis based of the findings of Doppler ultrasonography.

KEYWORDS:

Doppler; Pregnancy; Round ligament varicosity; Ultrasonography

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