Splenic pregnancy: a case report
Published in the Journal of Obstetrics and Gynaecology of India, the authors describe a case of a patient who presented with abdominal pain, pregnancy test positive and haemoperitoneum and was taken up for exploratory laparotomy, and splenic pregnancy was diagnosed intraoperatively. A splenorrhaphy was performed to conserve the spleen instead of splenectomy.

A 19-year-old married woman presented with abdominal pain and fullness since two days. She had regular menstrual cycles. Her last menstruation was 4 weeks prior. An abdominal ultrasound was done at the peripheral hospital, which revealed a normal uterus, normal bilateral fallopian tubes and ovaries, and moderate to severe haemoperitoneum and all abdominal organs within normal limits. A urine pregnancy test done there was positive.

Since the patient was haemodynamically unstable, pregnancy test was positive along with haemoperitoneum, she was taken up for an emergency exploratory laparotomy under general anaesthesia, with clinical suspicion of a ruptured ectopic pregnancy, probably undiagnosed radiologically.

The uterus, bilateral fallopian tubes and ovaries were normal, and no evidence of a tubal or ovarian ectopic pregnancy was found. Meanwhile, her serum beta HCG value sent on admission was found to be more than 10,000 mIU/ml. A careful exploration of the abdomen revealed fresh blood clots and blood collection in the left paracolic area, which was traced to originate from the spleen. The spleen on its supero-lateral surface showed attachment of irregular soft, chorionic villous /trophoblast-like tissue, approximately 3 × 2 cm in size. Active bleeding from the superolateral surface of the spleen was present.

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