More Swelling

A 29 year old lady in her second pregnancy presents at 36 weeks of gestation with a palpable mass in her right groin for two weeks, which has slowly increased in size.

There was no associated abdominal pain, while her bowel habits were unaltered. Her pregnancy was otherwise unremarkable so far.

Her first pregnancy was uneventful.

Select Relevant Investigations
Ultrasound Abdomen

Performed

There is a 2.5 x 3 cm mass in the right groin, with a prominent venous plexus and multiple dilated draining veins. There is no sonographic evidence of herniated bowel or lymph nodes.
Color Doppler of Mass

Performed

The mass is hypervascular, with abundant venous flow, which is augmented by the valsalva maneuver. The veins are noted to drain into the inferior epigastric vein.
CT Angiography

Performed

You recall that intravenous contrast agents are best avoided during pregnancy.
Transvaginal Ultrasound

Performed

A single fetus in the left anterior position is seen; the placenta is located posteriorly; an adequate amount of amniotic fluid is present, with an amniotic fluid index (AFI) of 8.0.

Select Relevant Management
Surgical Exploration
Urgent LSCS
NSAIDS
Monitor with Ultrasound