Complications of Round Ligament Varicosities

Athwal et al. have provided details about an interesting case of round ligament varicosities. ¹ Varicose veins of the round ligament though rare need to be followed closely as they may result in a number of serious complications.

Pain in patients with varicose veins of the round ligament may point towards possible thrombosis. Such patients may need surgery or in some cases can be managed medically. Thrombus formation is common in the postpartum period. ² Rarely the veins may rupture; this may result in the formation of a haemoperitoneum. This scenario is more commonly seen in patients with cirrhosis and subsequent portal hypertension. ³ In such cases surgery is required and involves ligation of the bleeding varicose vein.

Rupture may occur in pregnancy also. In such cases the presentation may be confused with that of a strangulated hernia and requires careful evaluation. Round ligament varicosities are usually unilateral. However, pregnant patients’ with bilateral varicosities of the round ligament have also been reported. ⁴

Clearly varicose veins of the round ligament though rare still need to be considered especially if the patient presents with a mass clinically suggestive of an inguinal hernia.