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Rare cause of bilateral groin swelling: Round ligament varicosities.

Bulbul E, Taskin MI, Yanik B, Demirpolat G, Adali E, Basbug M - Pak J Med Sci (2015 Jul-Aug)

Bottom Line: Round ligament varicosity (RLV) is rare and almost all cases are pregnant women.Pain and tenderness may present.Clinical evaluation is inadequate for exact diagnosis because inguinal hernia has similar findings.

View Article: PubMed Central - PubMed

Affiliation: Erdogan Bulbul, Department of Radiology, Balikesir University Faculty of Medicine, Balikesir, Turkey.

ABSTRACT
Round ligament varicosity (RLV) is rare and almost all cases are pregnant women. RLV appears as a unilateral or bilateral groin swelling. Pain and tenderness may present. Clinical evaluation is inadequate for exact diagnosis because inguinal hernia has similar findings. Ultrasonography (US) is essential when a groin swelling is detected in a pregnant woman. We present gray scale US and colour Doppler US findings of a 32-week pregnant woman with bilateral RLVs at the inguinal canal, parauterine area and in the myometrium.

No MeSH data available.


Related in: MedlinePlus

Gray scale and colour Doppler ultrasonography (US) reveals dilated, tortuous channels (white arrows) at the left inguinal region (a, b).
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Figure 1: Gray scale and colour Doppler ultrasonography (US) reveals dilated, tortuous channels (white arrows) at the left inguinal region (a, b).

Mentions: A 32- year old pregnant woman, parity 1, presented with bilateral painless groin swelling. Her first pregnancy was uneventful. Groin swelling firstly appeared on the left side at 16 week of second pregnancy followed by the other side. The masses gradually increased and patient was consulted by a surgeon at the 32rd gestational week. Bilateral reducible soft masses with enlargement by cough impulse were detected at physical examination. Patient was referred to radiology department for ultrasound evaluation. The gray scale US and colour Doppler US of the inguinal canal was performed with a Siemens-Acuson S2000 scanner (Siemens Healthcare, Erlangen, Germany) and a 4-9 MHz multifrequency linear-array transducer. Ultrasound revealed bilateral inguinal anechoic, compressible, tubular, tortuous channels. Venous flow detected within the channels by colour Doppler US and spectral analysis. The lesions showed continuity through the internal inguinal ring and extended to parauterine space and myometrium (Fig. 1, 2 and 3). Tubular channels were also seen through the labium major. The lesions became prominent with Valsalva manoeuvre and erect position. Based on the ultrasound findings RLVs diagnosed. The patient was closely followed-up, and had an elective caesarean section. Groin swelling regressed within four weeks without any complications.


Rare cause of bilateral groin swelling: Round ligament varicosities.

Bulbul E, Taskin MI, Yanik B, Demirpolat G, Adali E, Basbug M - Pak J Med Sci (2015 Jul-Aug)

Gray scale and colour Doppler ultrasonography (US) reveals dilated, tortuous channels (white arrows) at the left inguinal region (a, b).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590387&req=5

Figure 1: Gray scale and colour Doppler ultrasonography (US) reveals dilated, tortuous channels (white arrows) at the left inguinal region (a, b).
Mentions: A 32- year old pregnant woman, parity 1, presented with bilateral painless groin swelling. Her first pregnancy was uneventful. Groin swelling firstly appeared on the left side at 16 week of second pregnancy followed by the other side. The masses gradually increased and patient was consulted by a surgeon at the 32rd gestational week. Bilateral reducible soft masses with enlargement by cough impulse were detected at physical examination. Patient was referred to radiology department for ultrasound evaluation. The gray scale US and colour Doppler US of the inguinal canal was performed with a Siemens-Acuson S2000 scanner (Siemens Healthcare, Erlangen, Germany) and a 4-9 MHz multifrequency linear-array transducer. Ultrasound revealed bilateral inguinal anechoic, compressible, tubular, tortuous channels. Venous flow detected within the channels by colour Doppler US and spectral analysis. The lesions showed continuity through the internal inguinal ring and extended to parauterine space and myometrium (Fig. 1, 2 and 3). Tubular channels were also seen through the labium major. The lesions became prominent with Valsalva manoeuvre and erect position. Based on the ultrasound findings RLVs diagnosed. The patient was closely followed-up, and had an elective caesarean section. Groin swelling regressed within four weeks without any complications.

Bottom Line: Round ligament varicosity (RLV) is rare and almost all cases are pregnant women.Pain and tenderness may present.Clinical evaluation is inadequate for exact diagnosis because inguinal hernia has similar findings.

View Article: PubMed Central - PubMed

Affiliation: Erdogan Bulbul, Department of Radiology, Balikesir University Faculty of Medicine, Balikesir, Turkey.

ABSTRACT
Round ligament varicosity (RLV) is rare and almost all cases are pregnant women. RLV appears as a unilateral or bilateral groin swelling. Pain and tenderness may present. Clinical evaluation is inadequate for exact diagnosis because inguinal hernia has similar findings. Ultrasonography (US) is essential when a groin swelling is detected in a pregnant woman. We present gray scale US and colour Doppler US findings of a 32-week pregnant woman with bilateral RLVs at the inguinal canal, parauterine area and in the myometrium.

No MeSH data available.


Related in: MedlinePlus