Saphena varix

Last revised by Travis Fahrenhorst-Jones on 28 Sep 2022

Saphena varix refers to a dilation of the great saphenous vein at its junction with the femoral vein at the level of the groin.

Saphena varix is a rare condition 4

A saphena varix presents as a reducible swelling in the groin that may be confused for a femoral hernia. The swelling may elicit a cough impulse as well as reduce upon laying down 1. The swelling may reach the size of a golf ball or even larger 2.  If thrombosed the clinical picture may be further clouded as the mass may become irreducible 1.

The suspicion of a saphena varix is supported by concurrent varicosities present on the lower limbs 2,3. The condition can however appear as an isolated mass 4

The varix is caused by valvular incompetence and is therefore usually also associated with significant varicosities elsewhere along the saphenous system 1,2

Ultrasound reveals a compressible expansile mass that will respond when the patient is asked to cough or Valsalva 3. Color flow Doppler demonstrates blood flow within the mass that fills from the bottom and is traceable from the great saphenous vein to the femoral vein 3

The condition is treated with high saphenous ligation 3

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