Gynecology & Obstetrics
Open Access

Abstract

Failure of partial splenectomy to treat splenic ectopic pregnancy

Ka Geen Cheung

Primary splenic ectopic pregnancies are extremely rare and difficult to diagnose. To our knowledge only 24 published cases exist since 1970. The majority required a total splenectomy for treatment. Two cases were managed conservatively with methotrexate injections, and one was successfully treated with a partial splenectomy only. We present a case of a 31 year old female in which an inital partial splenectomy was unsuccesful in removing the ectopic pregnancy. Due to rising postoperative b-HCG levels, a CT and USS confirmed that the ectopic pregnancy had been left in the remaining spleen. She was taken to theatre again where a total laparoscopic splenectomy was performed. Her recovery was uneventful. Due to the rarity of splenic ectopic pregnancies, and the difficulty in visualising ectopic tissue on a spleen, particularly in the presence of haemoperitoneum, we recommend that surgeons performing a partial splenectomy should confirm the presence of fetal tissue with a pathology service during the intraoperative period.

Published Date: 2020-08-31; Received Date: 2020-08-01