Preoperative splenic artery embolization for splenic ectopic pregnancy

Abstract

Primary splenic pregnancy is an extremely rare form of extra tubal ectopic pregnancy. Trans-arterial embolization is emerging as an effective treatment for ectopic pregnancy. Here, we present a 34-year-old G4P3003 woman who presented with vaginal bleeding and elevated serum quantitative human chorionic gonadotropin (beta-hCG). After initial workup showed no intrauterine pregnancy, MRI of the abdomen showed an ectopic gestational sac at the splenic hilum. A preoperative splenic artery embolization was performed successfully prior to open splenectomy for removal of the ectopic pregnancy to minimize operative blood loss. By sharing our experience in this case, we contribute to the validation of trans-arterial embolization as an effective adjunctive measure in treating ectopic pregnancy.

Keywords: Ectopic pregnancy; Splenectomy; Splenic artery embolization.

Fig. 1

T2 diffusion-weighted image showing a cystic structure with a hypointense central focus representing the fetal pole within a gestational sac (red arrow) at the splenic hilum.

Fig. 2

Selective splenic arteriography showing abnormal enhancing vessels with a central avidly enhancing focus corresponding to the fetal pole (red arrow) in the inferior aspect of the splenic hilum.

Fig. 3

Gross image of ectopic pregnancy adherent to the splenic hilum.