Primary splenic pregnancy: a case report

Abstract Background Abdominal pregnancy refers to the implantation of a fertilized egg in the abdominal cavity outside of the uterus, fallopian tubes, and ovaries; splenic pregnancy is a rare type of abdominal pregnancy. Case presentation Our patient was a 24-year-old Han Chinese female individual who presented to our hospital with left lower abdominal pain for 12 days. The patient complained of 59 days of amenorrhoea and a small amount of vaginal bleeding 2 weeks earlier, and had previously undergone tubal recanalization for “bilateral tubal obstruction.” There was no other significant medical history. The patient’s serum beta human chorionic gonadotropin level of 20,447 IU/L was significantly higher than normal, but repeated ultrasound examinations did not reveal a gestational sac in the uterine cavity. Therefore, the patient was highly suspected to have an ectopic pregnancy. An abdominal ultrasound scan was performed to clarify the diagnosis, and an irregular, slightly hyperechoic area was found in the spleen, which led to the diagnosis of splenic pregnancy. Postoperative pathology confirmed a splenic pregnancy. Conclusion Splenic pregnancy is difficult to diagnose owing to the lack of typical clinical manifestations. Expanded ultrasound scanning or computed tomography/magnetic resonance imaging can help to detect ectopic pregnancy lesions, and laparoscopic exploration can be performed when necessary in patients who cannot be definitively diagnosed.