{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:33:23Z","timestamp":1768433603938,"version":"3.49.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2013,12,20]],"date-time":"2013-12-20T00:00:00Z","timestamp":1387497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>No consensus exists regarding definitive management of colonic perforation in Ehlers-Danlos syndrome (EDS), with various authors advocating different operative techniques. Spontaneous colonic perforation is a recognised complication of vascular-type EDS (type IV), with many reported cases in the literature. No such cases have been reported concerning classical-type EDS (type I\/II).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PRESENTATION OF CASE:<\/jats:title>\n                    <jats:p>A 55-year-old male with a family history of EDS presented with acute lower abdominal pain and signs of localised peritonitis. Following resuscitation, computerised tomography identified perforation of a sigmoid diverticulum with localised intraperitoneal air. Considering the potential complications associated with laparotomy in a patient with EDS, a trial of conservative management was undertaken including image-guided drainage of a mesenteric abscess. Intensive care monitoring, nutritional support and intravenous antibiotics also facilitated successful non-operative management. Following discharge, molecular studies confirmed COL5A1 mutation, and a diagnosis of classical Ehlers-Danlos syndrome was established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>This is the first reported case of successful conservative management of colonic diverticular perforation in a patient with classical Ehlers-Danlos syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>EDS is highly significant in the surgical context, with the causative genetic factors serving to further complicate the course of surgical intervention. In the absence of consensus regarding best surgical management, due consideration should be given to non-operative management of benign colonic perforation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2013.12.024","type":"journal-article","created":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T05:30:51Z","timestamp":1389159051000},"page":"135-137","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Non-operative management of diverticular perforation in a patient with suspected Ehlers-Danlos syndrome"],"prefix":"10.1097","volume":"5","author":[{"given":"M.C.","family":"Casey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.S.","family":"Waters","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Hanaghan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Barry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R2-7-20260114","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1750-1172-2-32","article-title":"Ehlers-Danlos syndrome type IV","volume":"2","author":"Germain","year":"2007","journal-title":"Orphanet J Rare Dis"},{"key":"R3-7-20260114","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/(SICI)1096-8628(19980428)77:1<31::AID-AJMG8>3.0.CO;2-O","article-title":"Ehlers-Danlos syndromes: revised nosology, Villefranche, 1997","volume":"77","author":"Beighton","year":"1998","journal-title":"Am J Med Genet"},{"key":"R4-7-20260114","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/j.1365-2141.2004.05220.x","article-title":"Bleeding and bruising in patients with Ehlers-Danlos syndrome and other collagen vascular disorders","volume":"127","author":"De Paepe","year":"2004","journal-title":"Br J Haematol"},{"key":"R5-7-20260114","first-page":"242","article-title":"'Hyperextensive' review of Ehlers-Danlos syndrome","volume":"82","author":"Fernandes","year":"2008","journal-title":"Cutis"},{"key":"R6-7-20260114","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1097\/GIM.0b013e3181eed412","article-title":"Clinical, genetic aspects of Ehlers-Danlos syndrome, classic type","volume":"12","author":"Malfait","year":"2010","journal-title":"Genet Med"},{"key":"R7-7-20260114","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1136\/gut.10.12.1004","article-title":"Gastrointestinal complications of the Ehlers-Danlos syndrome","volume":"10","author":"Beighton","year":"1969","journal-title":"Gut"},{"key":"R8-7-20260114","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1002\/bjs.1800560404","article-title":"Surgical aspects of the Ehlers-Danlos syndrome, a survey of 100 cases","volume":"56","author":"Beighton","year":"1969","journal-title":"Brit J Surg"},{"key":"R9-7-20260114","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/s00428-007-0415-6","article-title":"Pathology of the large intestine in patients with vascular type Ehlers-Danlos syndrome","volume":"450","author":"Bl\u00e4ker","year":"2007","journal-title":"Virchows Arch"},{"key":"R10-7-20260114","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1056\/NEJM200003093421001","article-title":"Genetic features of Ehlers-Danlos syndrome Type IV, the vascular type","volume":"342","author":"Pepin","year":"2000","journal-title":"N Engl J Med"},{"key":"R11-7-20260114","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1007\/BF02049321","article-title":"Surgical pitfalls in a patient with type IV Ehlers-Danlos syndrome and spontaneous colonic rupture. 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