Abstract
Round ligament varicosities (RLV) can be easily misdiagnosed as inguinal hernia, because they share the same clinical manifestation. We report two pregnant women with a reducible groin mass in whom correct diagnosis of RLV was made by color Doppler ultrasonography. Case 1 was a 29-year-old woman. At 30 weeks gestation, she complained of inguinal swelling and discomfort. She was referred to department of surgery by her obstetrician. Physical examination revealed a soft groin mass appearing in the standing position but disappearing in the recumbent position. B-mode ultrasonography showed a well-demarcated low echoic mass (4 x 3 cm in size) with a tubular structure extending to the uterus. Color Doppler ultrasonography demonstrated blood flow in the mass, which was augmented by the Valsalva maneuver, after which the diagnosis of RLV was made. The size of the varicosities was increased to 6 x 3 cm at 34 weeks gestation. When she gave birth by cesarean section at 37 weeks gestation, the RLV was confirmed on laparotomy. After the delivery, the groin mass was remarkably reduced. Case 2 was a 36-year-old woman. She had left inguinal pain at 28 weeks gestation and came to the department of surgery. Physical examination revealed a soft groin mass appearing in the standing position but vanishing in the recumbent position. B-mode ultrasonography showed a low echoic fusiform mass in the left inguinal region, in which color Doppler ultrasonography demonstrated blood flow augmented by the Valsalva maneuver. The diagnosis of RLV was made. Because most RLV resolve spontaneously postpartum, they should be managed conservatively. Color Doppler ultrasonography is useful for correct diagnosis of RLV to avoid unnecessary surgery.
