Round ligament varicocele.

A 24-year-old pregnant woman (at 25 weeks gestation) was referred to our department because of a painless swelling in the left groin which she was feeling for one week. The swelling was more apparent in the upright position and when coughing. The swelling was reducible. Ultrasound demonstrated an anechoic structure with intralesional septa at the left inguinal area (Fig. A, longitudinal ultrasound image). The lesion augmented with the Valsalva manoeuvre and in standing position. Power Doppler confirmed the presence of venous flow (Fig. B). Inverted venous flow was seen after Valsalva (Fig. C, arrow). Based on the imaging findings the presumptive diagnosis of round ligament varicocele was made. The lesion was managed with watchful waiting and resolved completely in the postpartum period. In her second pregnancy the lesion recurred, again with complete resolution after delivery.