Splenic Pregnancy: A Case Report

Thomas, Anuja; Srivastava, Nimisha; Tintoiya, Iqbal; Kumar, Sushil

doi:10.1007/s13224-016-0947-2

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Three cases had been treated conservatively following diagnosis with a combination of intramuscular methotrexate injections with embolization or intra-gestational sac injection being performed in the other 2 cases [ 26 , 34 ]. Two cases were managed with splenorrhaphy [ 24 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Managing Ruptured Splenic Ectopic Pregnancy Without Splenectomy: Case Report and Literature Review

et al. 2021

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Splenic ectopic pregnancy is extremely rare but carries a high risk of uncontrollable life-threatening bleeding. Our aim is to try to diagnose those cases earlier and to include splenic preservation as good alternative for selected cases. Extensive review of the literature has been performed. Thirty-one case reports were identified, of which 4 have been excluded because they were not written in English. A 36-year-old woman presented to the Emergency Department with haemorrhagic shock. Despite the levonorgestrel intrauterine system (LNG-IUS) being in situ for 4 months, urinary and serum tests were both positive for pregnancy, and an ultrasound scan revealed haemoperitoneum suggestive of a ruptured ectopic pregnancy. An emergency Pfannenstiel laparotomy was performed and a diagnosis of spontaneous tubal abortion was made and the abdomen was subsequently closed. Following a period of cardiovascular instability on the Intensive Care Unit postoperatively, an urgent CT scan was performed which revealed bleeding from the spleen. A midline laparotomy was performed by the general surgeon, which involved resection of the gestational sac and splenorrhaphy. Twenty-seven cases were reviewed, and 73% of them presented as an emergency and 21 cases (81%) had been managed with splenectomy. CT scan had been used in eight of the previous case reports of splenic ectopic pregnancy with 100% diagnostic accuracy rate. Non-tubal ectopic pregnancies are very rare. Splenorrhaphy is a safe alternative to splenectomy in cases of splenic ectopic pregnancy. CT abdomen and pelvis with intravenous contrast can be very helpful in relatively stable patients with a vaginal ultrasound demonstrating an empty uterus, no clear adnexal masses or free fluid.

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Section: Discussionmentioning

confidence: 99%

Managing Ruptured Splenic Ectopic Pregnancy Without Splenectomy: Case Report and Literature Review

et al. 2021

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Primary splenic ectopic pregnancy: A case report and literature review of a rare issue

Paolo,

Maria,

Vivian

et al. 2024

J of Obstet and Gynaecol

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AimPrimary splenic pregnancy is a rare form of extratubal ectopic pregnancy, frequently associated with life‐threatening abdominal bleeding, with only 51 cases reported in the worldwide literature. The aim of this work, through the proposal of its own index case, is to identify the fundamental steps of the diagnostic process, crucial to reduce the mortality rate, while evaluating the available therapeutic options, through a review of the literature, particularly the more conservative ones, to avoid splenectomy.MethodsWe present the case of a 22‐year‐old woman, showing her diagnostic‐therapeutic pathway. We searched Pubmed and other sources for all publications in English and all available non‐English literature, including historical publications, on this rare topic, to identify the best treatment for these patients. We classified each article by clinical onset, diagnostic and therapeutic strategy, and histological findings, if available.ResultsWe reviewed all the 43 cases available in the English‐language literature (plus another paper in German), finding that 72.7% of patients presented in an emergency setting. Seventy‐five percent of patients required splenectomy, 6.8% received pharmacological‐only therapy, 11.3% received arterial embolization before definitive treatment. The other ones received non‐radical surgical treatment.ConclusionsPrimary splenic pregnancy presents challenging diagnostic and therapeutic features. Treatment options (pharmacological, interventional, and/or surgical) should be tailored based on the clinical presentation and hemodynamic status of the patient. Our work would like to stimulate the validation of evidence‐based therapeutic strategies validated by clinical experience.

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Splenic Pregnancy: A Case Report

Cited by 2 publications

References 6 publications

Managing Ruptured Splenic Ectopic Pregnancy Without Splenectomy: Case Report and Literature Review

Managing Ruptured Splenic Ectopic Pregnancy Without Splenectomy: Case Report and Literature Review

Primary splenic ectopic pregnancy: A case report and literature review of a rare issue

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