Venous aneurysms of saphena magna: is this really a rare disease?

Abstract

We read with interest the article by Tschuor et al. [1] recently published in your journal and would like to comment on it. Despite being well documented, the authors reported a case of ‘‘rare’’ venous aneurysm. Even if they state an atypical diagnostic workflow leading to an intraoperative ‘‘surprise’’ of an uncommon venous aneurysm finding, we would like to say that looking at the published image of the upper thigh (Fig. 1 of the published article), it is very clear that this ‘‘hernia’’ is surely not an inguinal hernia but could be, in the best hypothesis, a femoral one (even if it seems to be very deep in its location, and usually femoral hernias are clinically diagnosed at the level of Malgaigne line under the inguinal ligament). But also in this case, if (as the author declared in the article) during MRI the sac was spontaneously reducible, it is hardly believable that such a large femoral hernia is so easily ‘‘spontaneously’’ reducible. In fact, from common clinical practice, the hole of femoral hernias is very often a very small defect and often these hernias are not spontaneously reducible like, for example, inguinal ones, and it is not infrequent that such small sacs are incarcerated [2]. Reading the article, it seemed to us very strange that an MRI did not have enough quality to clearly distinguish a venous aneurysm from a hernia’s sac. Furthermore, the preoperative work-up was affected by a mistake in the workflow of diagnostic imaging, in fact, in our opinion, the authors should have first performed a very simple US-scan integrated by color Doppler exploration of the sapheno-femoral junction that is cost-effective and less invasive than MRI. This simple examination can very easily differentiate between a hernia sac, a lipoma, a lymphadenopathy, or venous aneurysm or others [3, 4]! Even an accurate clinical examination (nowadays uncommonly done because of the availability of other technologies) could distinguish between a hernia and a

DOI: 10.1007/s10029-012-1003-5

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Cite this paper

@article{Donati2012VenousAO, title={Venous aneurysms of saphena magna: is this really a rare disease?}, author={Matilde Donati and Alberto Biondi and Giovanna Brancato and A Donati and Fadi Basile}, journal={Hernia}, year={2012}, volume={17}, pages={115-117} }