Primary Abdominal Ectopic Pregnancy Involving the Spleen: A Case Study

Area of Science:

• Reproductive Medicine
• Surgical Gynecology
• Diagnostic Imaging

Background:

• Ectopic pregnancy is a significant cause of first-trimester maternal morbidity and mortality.
• Abdominal pregnancies are rare but carry high risks of complications.
• Splenic implantation of an ectopic pregnancy is exceptionally rare.

Purpose of the Study:

• To report a rare case of ectopic pregnancy implanted in splenosis.
• To highlight diagnostic challenges and management strategies for atypical ectopic pregnancies.
• To emphasize the importance of timely surgical intervention.

Main Methods:

• A 29-year-old patient presented with symptoms suggestive of ectopic pregnancy.
• Diagnostic workup included serum beta-hCG levels and serial ultrasounds.
• Exploratory laparoscopy was performed due to diagnostic uncertainty.
• Histological analysis confirmed ectopic pregnancy in splenic tissue.

Main Results:

• Laparoscopy revealed vascularized formations on the prevesical peritoneum, which were excised.
• Postoperative beta-hCG levels declined significantly.
• Histology confirmed chorionic villi and trophoblast cells within splenic tissue, consistent with ectopic pregnancy in splenosis.
• The patient recovered well with near-complete resolution of beta-hCG.

Conclusions:

• This case underscores the possibility of ectopic pregnancy implantation in unusual locations like splenosis.
• Inconclusive imaging and rising beta-hCG necessitate thorough investigation, potentially including laparoscopy.
• Prompt surgical management is critical for favorable outcomes in rare ectopic pregnancy presentations.