Gynäkologie und Geburtshilfe
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Versagen der partiellen Splenektomie zur Behandlung einer Milz-Eileiterschwangerschaft

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.