Inguinal pain during pregnancy, secondary to round ligament varicosities: case report

Gamaliel Vázquez Estudillo, Junior J. Araiza Navarro, Martin F. Tellez Romero, Rogelio Mata Cruz, Ivanhoe Larracilla Salazar, Alex Simon Mendoza


The exact incidence of round ligament varicosities (RLV) is uncertain, due to the fact that there are few cases reported in the literature, and in many cases, they can be confused with inguinal hernias. A 26-year-old female with 26.3 weeks of gestation by date of last menstruation, who went to the emergency service of the Naval Regional Hospital of Tampico with the presence of an increase in volume in the left inguinal region, accompanied by pain, which increased standing and decreasing with the dorsal decubitus, the physical examination confirmed an increase in volume at the left inguinal level. An ultrasound of the inguinal region was requested to rule out an inguinal hernia as the first diagnosis, Doppler ultrasound revealed RLV. The patient was treated conservatively and at two weeks after the resolution of the pregnancy, the RLV presented a spontaneous regression and her symptoms completely resolved. This is the first case of round ligament varicosities reported in present institution. It is important to be aware of this pathology, to perform extension studies (Doppler ultrasound) to avoid unnecessary surgery in pregnant women.


Doppler ultrasound, Inguinal canal, Inguinal ultrasonography, Pregnant women, Round ligament, Round ligament varicosities

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Uzun M, Akkan K, Coskun B. Round ligament varicosities mimicking inguinal hernias in pregnancy: importance of color Doppler sonography. Diagnost Interventional Radiol. 2010;16(2):150.

Copete MC, Ruiz MC, Yánez RJ, López LH. Varicose veins in the round ligament. Radiol. 2010;52(1):81-4.

Garcia-Paredes LF, Torres-Ayala SC, Rivera-Hernández W, Mojica WR. A case of round ligament varices presenting in pregnancy. Am J Case Rep. 2017;18:1194.

Ryu KH, Yoon JH. Ultrasonographic diagnosis of round ligament varicosities mimicking inguinal hernia: report of two cases with literature review. Ultrasonography. 2014;33(3):216-21.

McKenna DA, Carter JT, Poder L, Gosnell JE, Maa J, Pearl JM, et al. Round ligament varices: sonographic appearance in pregnancy. Ultrasound Obstet Gynecol: Offic J Int Soc Ultrasound Obstet Gynecol. 2008;31(3):355-7.

Lechner M, Fortelny R, Öfner D, Mayer F. Suspected inguinal hernias in pregnancy-handle with care!. Hernia. 2014;18(3):375-9.

Reisfield DR. Varicosities in veins of the inguinal canal during pregnancy. J Med Soc New Jersey. 1962;59:24.

Frede TE. Ultrasonic visualization of varicosities in the female genital tract. J Ultrasound Med. 1984;3(8):365-9.

Cheng D, Lam H, Lam C. Round ligament varices in pregnancy mimicking inguinal hernia: an ultrasound diagnosis. Ultrasound Obstet Gynecol. 1997;9(3):198-9.

Yonggang H, Jing Y, Ping W, Guodong G, Chenxia M, Xiaojing X, et al. Forty-one cases of round ligament varicosities that are easily misdiagnosed as inguinal hernias. Hernia. 2017;21(6):901-4.

Mine Y, Eguchi S, Enjouji A, Fukuda M, Yamaguchi J, Inoue Y, et al. Round ligament varicosities diagnosed as inguinal hernia during pregnancy: A case report and series from two regional hospitals in Japan. Int J Surg Case Rep. 2017;36:122-5.