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41例圆韧带静脉曲张,易被误诊为腹股沟疝。

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

作者信息

Yonggang H, Jing Y, Ping W, Guodong G, Chenxia M, Xiaojing X, Fangjie Z, Hao W

机构信息

Department of Hernia and Abdominal Wall Surgery, Hangzhou First People's Hospital, Hangzhou, China.

Department of Ultrasonography, Hangzhou First People's Hospital, Hangzhou, China.

出版信息

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.

摘要

目的

证明对易被误诊为腹股沟疝的圆韧带静脉曲张(RLV)进行保守治疗的益处和安全性。

方法

我们回顾性分析了2011年1月至2015年12月在一家医院通过超声诊断的41例连续RLV临床资料。记录误诊率、临床和超声特征、诊断后的处理及预后情况。

结果

41例均为孕中期或孕晚期女性。28例最初被误诊为腹股沟疝(68.3%)。30例表现为腹股沟区可复性肿胀(73.2%),其中25例伴有疼痛(61.0%)。4例仅感腹股沟区疼痛无肿胀(9.7%)。7例无明显不适(17.1%)。所有病例均通过灰阶和彩色多普勒超声诊断为RLV,并采取观察等待策略。37例随访至产后完全恢复(随访率90.2%)。产后肿胀无论有无疼痛均自行消失。

结论

RLV易被误诊为腹股沟疝,腹股沟区彩色多普勒超声是做出正确诊断的最佳检查方法。经彩色多普勒超声确诊后,RLV的保守治疗有益且安全。

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