Ruptured splenic ectopic pregnancy: A rare and life-threatening case report

Splenic ectopic pregnancy (SEP) is a rare and potentially life-threatening form of extrauterine gestation. Timely diagnosis is critical due to the risk of spontaneous rupture and hemoperitoneum. A 30-year-old woman presented with acute abdominal pain and secondary amenorrhea. Laboratory tests showed markedly elevated serum and urine β-hCG. Transabdominal ultrasound revealed significant hemoperitoneum without evidence of intrauterine or adnexal pregnancy. Contrast-enhanced computed tomography (CT) demonstrated a heterogeneous mass within the spleen and free intraperitoneal fluid, raising suspicion for SEP. The patient underwent emergency laparotomy and splenectomy. Histopathological examination confirmed chorionic villi within the splenic tissue. Although exceedingly rare, SEP should be included in the differential diagnosis of acute abdomen in women of reproductive age with positive β-hCG and no intrauterine gestation on imaging. Early recognition and prompt surgical intervention are essential to reduce morbidity and mortality.