Sarcina splenica primara reprezinta o forma rara de sarcina ectopica. Recunoasterea acestei forme de sarcina este cruciala,
datorita riscului de sangerare si deces si ar trebui luata in considerare in diagnosticul diferential al abdomenului acut la femeile
de varsta reproductiva. Obiectivul studiului. Cercetarea literaturii de specialitate cu evidentierea mecanismelor etiopatogenice,
manifestarilor clinice caracteristice, metodelor de diagnostic si managementul sarcinii primare splenice.
Material si metode: O revizuire sistematica a literaturii a fost efectuata conform PRISMA din bazele de date on-line PubMed si Google
Scholar utilizand urmatoarele cuvinte cheie: „sarcina splenica”, „sarcina lienala primara” cu identificarea a 29 de cazuri de sarcina
splenica raportate in perioada aa. 1977-2021.
Rezultate: Varsta medie - 28,97± 0.95 (95% CI: 27.00–30.93) variind de la 19 pana la 41 de ani. Patru bolnave au folosit
dispozitive intrauterine. Eruperea sarcinii ectopice a fost detectata in 9 cazuri. Dupa localizarea topografica, cel mai frecvent este
implicat polul inferior. Dimensiunile sarcinei splenice primare au variat de la 1.4 la 3.5 cm. In majoritatea cazurilor descise au fost
raportate nivelul β-hCG elevat semnificativ pana la 169959 IU/L cu scaderea progresiva a indicelui in perioada postoperatorie.
Splenectomia a fost efectuata in 23 de cazuri: prin abord deschis (n=21) si laparoscopic (n=2). In patru cazuri a fost utilizat
Methotrexate.
Concluzie: Identificarea sarcinii splenice primare reprezinta o provocare diagnostica dificila, examenul imagistic precoce cu utilizarea
ecografiei si tomografiei computerizate, sensibilitatea imbunatatita a testelor β-hCG in urina si serul sanguin poate reduce sau evita
un diagnostic eronat. Diagnosticul precoce al sarcinii splenice primare este crucial si poate preveni situatia cu potential letal.

Primary splenic pregnancy is rarely form of extrauterine pregnancy. Recognition of this form of gestation is of critical importance,
owing to the risk of exsanguination and death, and should be considered in the differential diagnosis of acute abdomen in women
of reproductive age. Objective of the study. Research of the specialty literature and highlighting about the mechanisms of formation,
clinical manifestations characteristic, methods of diagnosis and management of the primary splenic pregnacy.
Material and Methods: A systematic literature review was performed, according to the PRISMA statement from PubMed and Google
Scholar using the mesh terms: „splenic pregnancy”, „primary lienal pregnancy” with the identification of 29 cases of splenic
pregnancy reported in the period 1977-2021.
Results: The age of the patients ranged from 19 to 41 years, the mean age - 28,97± 0.95 years (95% CI: 27.00–30.93). Four patients
used intrauterine devices. Rupture of ectopic pregnancy was detected in 9 cases. After the topographic location, the lower pole is
most commonly involved. The dimensions of the primary splenic pregnancy ranged from 1.4 to 3.5 cm. In most of the described
cases, the significantly elevated β-hCG level up to 169959 IU / L was reported with the progressive decrease of the index in the postoperative
period. Open (n=21) or laparoscopic (n=2) splenectomy was performed in 23 cases. Methotrexate was used in four cases.
Conclusion: Detection of primary splenic pregnancy poses a difficult diagnostic challenge, early imaging study with ultrasonography
and computed tomography, improved sensitivity of urine and serum β-hCG tests could reduce or avoid the
misdiagnosis. Early diagnosis of primary splenic pregnancy is crucial and may avoid life-threatening situation.