China-Japan Union Hospital of Jilin University, Changchun, China.
J Obstet Gynaecol Res. 2021 Oct;47(10):3716-3719. doi: 10.1111/jog.14950. Epub 2021 Aug 2.
The subject, splenic pregnancy, is very rare and interesting with about a few cases reported to date. This case report describes a healthy 17-year-old girl admitted to our hospital who complained of amenorrhea for 30 days, intermittent abdominal pain for 3 days and worsening for 1 h. The serum human chorionic gonadotropin (hCG) was greater than 10000.0 IU/L. Pelvic ultrasonography showed a adnexal mass and empty uterine cavity. Due to consideration of "ectopic pregnancy," emergency laparoscopic surgery was performed. However, no clear lesions and bleeding points were detected during the operation. On postoperative day 2, hemoglobin level dropped sharply, meanwhile serum hCG increased significantly. Subsequent ultrasound showed a 4.4 × 4.1 × 2.6 cm gestational sac-like echo below the spleen. Laparotomy detected pregnancy tissues measured 4.0 × 3.5 cm next to the splenic hilum. Finally, the splenectomy was performed. Our case suggests that early diagnosis of splenic pregnancy is very difficult, especially when other conditions are combined. Despite this, we should still enrich ourself medical knowledge and clinical experience, and try to avoid the occurrence of splenic rupture.
主题，脾妊娠，非常罕见且有趣，迄今为止约有几例报道。本病例报告描述了一位健康的 17 岁女孩，因停经 30 天、间歇性腹痛 3 天且加重 1 小时入院。血清人绒毛膜促性腺激素（hCG）大于 10000.0 IU/L。盆腔超声显示附件包块和宫腔空虚。由于考虑“异位妊娠”，行急诊腹腔镜手术。但术中未发现明确的病变和出血点。术后第 2 天，血红蛋白水平急剧下降，同时血清 hCG 显著升高。随后的超声显示脾下有一个 4.4×4.1×2.6cm 的妊娠囊样回声。剖腹探查发现脾门旁妊娠组织大小为 4.0×3.5cm。最终行脾切除术。本病例提示脾妊娠早期诊断非常困难，尤其是合并其他情况时。尽管如此，我们仍应丰富自己的医学知识和临床经验，并尽量避免脾破裂的发生。
