García-Paredes Luis F, Torres-Ayala Stephanie C, Rivera-Hernández Wilmarie, Rodriguez Mojica Wilma
Ultrasound Section, Department of Diagnostic Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
Am J Case Rep. 2017 Nov 10;18:1194-1197. doi: 10.12659/ajcr.905753.
BACKGROUND Round ligament varices (RLV) are rare and are almost exclusively seen in pregnant women. RLV may clinically resemble an inguinal hernia, inguinal mass, or other pathology involving the inguinal canal and round ligament. Ultrasound imaging is important to make the diagnosis of RLV. CASE REPORT A 34-year-old Hispanic woman, gravida 1 para 0, at 34 weeks gestation, presented to our outpatient department with a complaint of a small, painless, reducible right inguinal mass. Gray-scale sonography showed an asymmetric right inguinal anechoic mass composed of multiple serpentine tubular channels, which became more prominent when the patient performed a Valsalva maneuver. Color Doppler ultrasound imaging showed a hyper vascular structure with a venous flow pattern, consistent with RLV. The patient was treated conservatively and had an uneventful vaginal delivery at 38 weeks gestation. At two weeks postpartum, the RLV spontaneously regressed and her symptoms completely resolved. CONCLUSIONS RLV is a rare condition that should be recognized and diagnosed promptly to prevent patients from undergoing unnecessary surgical exploration. Ultrasound is the diagnostic imaging procedure of choice for the diagnosis of RLV, as well as for patient follow-up and to exclude possible complications associated with RLV.
背景 圆韧带静脉曲张(RLV)较为罕见,几乎仅见于孕妇。RLV在临床上可能类似于腹股沟疝、腹股沟肿块或其他累及腹股沟管和圆韧带的病变。超声成像对于RLV的诊断很重要。病例报告 一名34岁的西班牙裔女性,孕1产0,妊娠34周,因右腹股沟有一个小的、无痛性、可复性肿块前来我院门诊就诊。灰阶超声显示右侧腹股沟区有一个不对称的无回声肿块,由多个蜿蜒的管状通道组成,患者做瓦尔萨尔瓦动作时更为明显。彩色多普勒超声成像显示一个具有静脉血流模式的高血管结构,符合RLV表现。患者接受保守治疗,妊娠38周时顺利经阴道分娩。产后两周,RLV自发消退,症状完全缓解。结论 RLV是一种罕见疾病,应及时识别和诊断,以避免患者接受不必要的手术探查。超声是诊断RLV以及对患者进行随访并排除与RLV相关的可能并发症的首选诊断成像方法。