Successful Laparoscopic Management of Early Splenic Pregnancy: Case Report and Review of Literature

Splenic pregnancy is the least common form of ectopic pregnancy. A 32-year-old woman, gravida 5, para 2, had not menstruated for 46 days, and had spotty bleeding for 6 days and lower abdominal pain for 2 days. The initial beta-human chorionic gonadotropin concentration was 38 913.3 IU/L. Transvaginal ultrasound examination demonstrated an empty uterine cavity, and a gestational sac 4.3 X 4.0 mm in diameter, with no fetal pole or yolk sac, located just adjacent to the splenic region. Laparoscopic surgery demonstrated intact pelvic organs and an ectopic mass on the spleen. The splenic pregnancy was successfully treated via laparoscopic embryo methotrexate injection, with preservation of the uterus and spleen. As evidenced in this case, laparoscopic embryo methotrexate injection is a minimally invasive and effective method of diagnosis and treatment of early splenic pregnancy. Journal of Minimally Invasive Gynecology (2010) 17, 794-797 (C) 2010 AAGL. All rights reserved.