{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:20:13Z","timestamp":1790248813319,"version":"4.1.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":266,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Ehlers-Danlos syndrome (EDS) is a rare and diverse group of heritable connective tissue disorders. Gastrointestinal manifestations and abdominal pain are frequent in most subtypes of EDS. Conservative treatment is the standard of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of the case<\/jats:title>\n                    <jats:p>A 43-year-old female patient with genetically confirmed EDS classic subtype presented with diffuse gastrointestinal symptoms (bloating, belching and pain) that were controlled by the patient through inclined posture and external abdominal compression. A standard abdominoplasty with rectus muscle plication and mesh implantation lead immediately to complete relief of symptoms, which allowed the patient to assume an upright posture and resume all daily activities again. After 7 years, the patient was again seen with severe, persistent abdominal pain and inclined posture related to right lumbar herniations, as confirmed by MRI. However, there was no recurrence of the previous abdominal midline weakness and related gastrointestinal symptoms. Following lumbar hernia repair and mesh implantation, the patient was free of abdominal pain and resumed an upright posture again.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Although conservative treatment of EDS is primarily recommended and most surgeons are reluctant to operate on these patients except in life threatening situations, we present the successful surgical relief of disabling abdominal symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Regarding the variability and complexity of symptoms in different subtypes of EDS, a personalized multimodal treatment including surgical approaches should be considered and achieved a significant and long-lasting improvement in quality of life in our patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.09.165","type":"journal-article","created":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T00:47:33Z","timestamp":1601081253000},"page":"14-18","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Surgical treatment of abdominal wall weakness and lumbar hernias in Ehlers-Danlos syndrome \u2013 Case report"],"prefix":"10.1097","volume":"76","author":[{"given":"Oliver","family":"Scheufler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian Ramin","family":"Andresen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reimer","family":"Andresen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-4-20260114","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S0929-6646(09)60187-X","article-title":"Clinical features of Ehlers-Danlos syndrome","volume":"105","author":"Yen","year":"2006","journal-title":"J. Formos. Med. Assoc"},{"key":"R2-4-20260114","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.clindermatol.2006.07.013","article-title":"Joint hypermobility and skin elasticity: the hereditary disorders of connective tissue","volume":"24","author":"Hakim","year":"2006","journal-title":"Clin. Dermatol"},{"key":"R3-4-20260114","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. Ehlers-Danlos National Foundation (USA) and Ehlers-Danlos Support Group (UK)","volume":"77","author":"Beighton","year":"1998","journal-title":"Am. J. Med. Genet"},{"key":"R5-4-20260114","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1399-0004.2012.01858.x","article-title":"The Ehlers-Danlos syndrome, a disorder with many faces","volume":"82","author":"De Paepe","year":"2012","journal-title":"Clin. Genet"},{"key":"R6-4-20260114","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/ajmg.c.31552","article-title":"The 2017 international classification of the Ehlers-Danlos syndromes","volume":"175","author":"Malfait","year":"2017","journal-title":"Am. J. Med. Genet. C Semin. Med. Genet"},{"key":"R7-4-20260114","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S0002-9343(03)00235-3","article-title":"Dysautonomia in the joint hypermobility syndrome","volume":"115","author":"Gazit","year":"2003","journal-title":"Am. J. Med"},{"key":"R8-4-20260114","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1093\/rheumatology\/keg370","article-title":"Joint mobility in people with hiatus hernia","volume":"43","author":"Al-Rawi","year":"2004","journal-title":"Rheumatology"},{"key":"R10-4-20260114","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/ajmg.a.33231","article-title":"Natural history and manifestations of the hypermobility type Ehlers-Danlos syndrome: a pilot study on 21 patients","volume":"152A","author":"Castori","year":"2010","journal-title":"Am. J. Med. Genet. A"},{"key":"R12-4-20260114","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1111\/nmo.12665","article-title":"Ehlers-Danlos syndrome and gastrointestinal manifestations: a 20-year experience at Mayo Clinic","volume":"27","author":"Nelson","year":"2015","journal-title":"Neurogastroenterol. Motil"},{"key":"R13-4-20260114","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.ejmg.2012.06.012","article-title":"Visceroptosis of the bowel in the hypermobility type of Ehlers-Danlos syndrome: presentation of a rare manifestation and review of the literature","volume":"55","author":"Reinstein","year":"2012","journal-title":"Eur. J. Med. Genet"},{"key":"R14-4-20260114","doi-asserted-by":"crossref","first-page":"e880321","DOI":"10.1371\/journal.pone.0080321","article-title":"Functional digestive symptoms and quality of life in patients with Ehlers-Danlos syndromes: results of a national cohort study on 134 patients","volume":"8","author":"Zeitoun","year":"2013","journal-title":"PLoS One"},{"key":"R15-4-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2018 statement: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R16-4-20260114","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1159\/000343738","article-title":"Gastrointestinal surgery and related complications in patients with Ehlers-Danlos syndrome: a systematic review","volume":"29","author":"Burcharth","year":"2012","journal-title":"Dig. Surg"},{"key":"R17-4-20260114","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":"R18-4-20260114","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1111\/j.1365-2133.1991.tb06063.x","article-title":"Platelet and coagulation studies in Ehlers-Danlos syndrome","volume":"125","author":"Anstey","year":"1991","journal-title":"Br. J. Dermatol"},{"key":"R19-4-20260114","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1159\/000346068","article-title":"Surgical recommendations in Ehlers-Danlos syndrome(s) need patient classification: the example of Ehlers-Danlos syndrome hypermobility type (a.k.a. Joint hypermobility syndrome)","volume":"29","author":"Castori","year":"2012","journal-title":"Dig. Surg"},{"key":"R20-4-20260114","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jpedsurg.2012.06.021","article-title":"Laparoscopic management of colonic complications in Ehlers-Danlos syndrome type IV","volume":"47","author":"Duthie","year":"2012","journal-title":"J. Pediatr. Surg"},{"key":"R21-4-20260114","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s13023-014-0109-5","article-title":"Recommendations for anesthesia and perioperative management in patients with Ehlers-Danlos syndrome(s)","volume":"9","author":"Wiesmann","year":"2014","journal-title":"Orphanet J. Rare Dis"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220308385?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220308385?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.09.165","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:23:34Z","timestamp":1768397014000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.09.165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":18,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.09.165","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}