Saphena Varix Mimicking Femoral Hernia in a Rural Elderly Patient: A Diagnostic Challenge in Primary Care

Abstract

Saphena varix is an uncommon venous dilation at the saphenofemoral junction that may clinically resemble a femoral hernia, resulting in diagnostic difficulties, particularly in primary care environments. We present a case of an 80-year-old male farmer from a rural background who exhibited a persistent swelling in the right groin area. The swelling started slowly, went down when the person lay down, and was linked to several dilated veins in the right lower limb and dull, aching pain that got worse by the end of the day. Clinical examination revealed a soft, compressible swelling with a cough impulse and palpable thrill, along with prominent tortuous varicose veins. Color Doppler imaging showed that the saphenofemoral junction was widening and that blood was flowing back, which is what you would expect with saphena varix and varicose veins.The patient had high ligation and stripping of the great saphenous vein, and the results were good. There was no recurrence after 18 months. This case underscores the necessity of meticulous clinical evaluation and suitable imaging to distinguish saphena varix from femoral hernia, while also stressing the imperative to enhance diagnostic capabilities in rural healthcare environments.