{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:10:12Z","timestamp":1756278612242,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,11,24]]},"abstract":"<jats:p>Abdominal ectopic pregnancy (EP) accounts for only 1.3% of EPs and occurs when a fertilised ovum implants in an extrapelvic peritoneal location. Primary splenic pregnancy is a rare type of abdominal EP, with only 16 cases previously reported in the literature. Early diagnosis is essential as delay in treatment carries significant potential for morbidity and mortality. We present the case of a 27-year-old woman presenting with left upper quadrant abdominal pain, elevated human chorionic gonadotropin levels, absence of intrauterine gestational sac and massive haemoperitoneum on transvaginal ultrasound. The patient underwent emergent surgical exploration for high suspicion of ruptured abdominal EP. An open splenectomy was performed when the source of bleeding was confirmed to originate from the left upper quadrant. Final pathology confirmed subcapsular gestational sac implantation within the spleen. While two cases of medical management have been reported, splenectomy remains the current definitive management of rare cases of primary splenic pregnancy.<\/jats:p>","DOI":"10.1136\/bcr-2016-218291","type":"journal-article","created":{"date-parts":[[2016,12,8]],"date-time":"2016-12-08T10:27:38Z","timestamp":1481192858000},"page":"bcr2016218291","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Management of splenic ectopic pregnancy presenting with massive haemoperitoneum"],"prefix":"10.1136","volume":"2016","author":[{"given":"Alissa","family":"Greenbaum","sequence":"first","affiliation":[{"name":"Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7108-3542","authenticated-orcid":false,"given":"Richard","family":"Miskimins","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of New Mexico, Albuquerque, New Mexico, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittany","family":"Coffman","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmeet","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,12,8]]},"reference":[{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.1","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.jmig.2010.07.004","article-title":"Successful laparoscopic management of early splenic pregnancy: case report and review of the literature","volume":"17","author":"Gang","year":"2010","journal-title":"J Minim Invasive Gynecol"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.12.3224"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/j.1445-2197.2009.05176.x","article-title":"Emergency laparoscopic splenectomy for haemoperitoneum because of ruptured primary splenic pregnancy: a case repot and review of the literature","volume":"80","author":"Biolchini","year":"2010","journal-title":"ANZ J Surg"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.4","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00404-016-4069-y","article-title":"Non-tubal ectopic pregnancy","volume":"294","author":"Parker","year":"2016","journal-title":"Arch Gynecol Obstet"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.5","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.ajog.2011.10.857","article-title":"Ectopic pregnancy not within the (distal) fallopian tube: etiology, diagnosis, and treatment","volume":"206","author":"Fylstra","year":"2012","journal-title":"Am J Obstret Gynecol"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.6","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1007\/s00270-016-1403-5","article-title":"Splenic pregnancy: a new minimally invasive approach to treatment","volume":"39","author":"Klang","year":"2016","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.7","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1016\/j.fertnstert.2004.10.047","article-title":"A case of simultaneous tubal-splenic pregnancy after assisted reproductive technology","volume":"83","author":"Kitade","year":"2005","journal-title":"Fertil Steril"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.8","doi-asserted-by":"publisher","DOI":"10.1159\/000342997"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.9","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S0002-9378(42)90488-5","article-title":"Primary peritoneal pregnancy","volume":"44","author":"Studdiford","year":"1942","journal-title":"Am J Obstet Gynecol"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.10","doi-asserted-by":"crossref","first-page":"146","DOI":"10.5858\/2004-128-e146-SPACRA","article-title":"Splenic pregnancy: a case report and review of the literature","volume":"128","author":"Kalof","year":"2004","journal-title":"Arch Pathol Lab Med"},{"key":"2025082623324416000_2016.dec08_1.bcr2016218291.11","first-page":"479","article-title":"Primary splenic pregnancy. 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