title: Ultrasound-Guided Percutaneous Management of Splenic Ectopic Pregnancy.
abstract: Splenic ectopic pregnancies are a rare cause of abdominal pain in reproductive-age women. A 21-year-old woman with worsening abdominal pain and a positive pregnancy test presented with hemoperitoneum and no intrauterine pregnancy on transvaginal ultrasound. After 2 nondiagnostic laparoscopies, a splenic pregnancy was diagnosed by computed tomography scan and abdominal ultrasound. Currently, diagnosis and treatment of splenic pregnancies involve exploratory surgery and splenectomy. We report the successful treatment of this splenic ectopic pregnancy with combined intramuscular plus ultrasound-guided percutaneous methotrexate injection, with preservation of the patient's spleen. Abdominal implantation must be considered in patients with pregnancy of unknown location, and in carefully selected patients splenic ectopic pregnancy can be successfully managed by minimally invasive methods.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Johanne L
authors.initials: JL
authors.lastname: Python
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Wakefield
authors.affiliation: Division of Interventional Radiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Kimi L
authors.initials: KL
authors.lastname: Kondo
authors.affiliation: Department of Radiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Tami J
authors.initials: TJ
authors.lastname: Bang
authors.affiliation: Division of Abdominal Imaging, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Stamm
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado. Electronic address: K.Joseph.Hurt@UCDenver.edu.
authors.forename: K Joseph
authors.initials: KJ
authors.lastname: Hurt
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000465:Algorithms; D057210:Delayed Diagnosis; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D007273:Injections, Intramuscular; D010535:Laparoscopy; D008727:Methotrexate / Q000627:therapeutic use*; D011247:Pregnancy; D011269:Pregnancy, Abdominal / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011271:Pregnancy, Ectopic / Q000175:diagnosis; D013154:Spleen; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D008727:Methotrexate
keywords: Abdominal pregnancy; Gynecology; Laparoscopy; Methotrexate; Pregnancy of unknown location