{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T06:58:54Z","timestamp":1761289134528,"version":"build-2065373602"},"reference-count":8,"publisher":"Bentham Science Publishers Ltd.","issue":"1","license":[{"start":{"date-parts":[[2011,9,23]],"date-time":"2011-09-23T00:00:00Z","timestamp":1316736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/legalcode"}],"content-domain":{"domain":["opencardiovascularmedicinejournal.com","benthamopen.com"],"crossmark-restriction":true},"short-container-title":["TOCMJ"],"published-print":{"date-parts":[[2011,9,23]]},"abstract":"<jats:p>\n                    Retroperitoneal hemorrhagic bleeding is a known manifestation of Type-IV Ehlers-Danlos Syndrome that is caused by loss-of-function mutations of the pro-alpha-1 chains of type III pro-collagen (\n                    <jats:italic>COL3A1<\/jats:italic>\n                    ) resulting in vascular fragility. A number of previous reports describe futile surgical intervention for retroperitoneal bleeding in Type-IV Ehlers-Danlos Syndrome with high post-operative mortality, although the rarity of retroperitoneal bleeding associated with Type-IV Ehlers-Danlos Syndrome precludes an evidence-based approach to clinical management. We report a 23-year-old male with history of Type-IV Ehlers-Danlos Syndrome who presented with severe abdominal pain and tachycardia following an episode of vomiting. Further work-up of his abdominal pain revealed massive retroperitoneal bleeding by CT-scan of the abdomen. Given numerous cases of catastrophic injury caused by surgical intervention in Type-IV Ehlers-Danlos Syndrome, the patient was treated non-operatively, and the patient made a full recovery. This case suggests that even in cases of large retroperitoneal hemorrhages associated with Ehlers-Danlos Syndrome, it may not truly represent a surgical emergency.\n                  <\/jats:p>","DOI":"10.2174\/1874192401105010210","type":"journal-article","created":{"date-parts":[[2011,9,28]],"date-time":"2011-09-28T06:05:56Z","timestamp":1317189956000},"page":"210-211","update-policy":"https:\/\/doi.org\/10.2174\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Type IV Ehlers-Danlos Syndrome: A Surgical Emergency? A Case of Massive Retroperitoneal Hemorrhage"],"prefix":"10.2174","volume":"5","author":[{"given":"Stephen G","family":"Chun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Pedro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihae","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danny M","family":"Takanishi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"965","reference":[{"key":"refR1","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1136\/pmj.78.922.501-a","volume":"78","author":"Soonawalla Z","year":"2002","unstructured":"Soonawalla Z, Pope FM, Puntis M. \n                Type IV Ehlers-Danlos syndrome: a surgical emergency \n                Postgrad Med J  \n                2002; \n                78\n                : 501-2.","journal-title":"Postgrad Med J"},{"key":"refR2","first-page":"974","volume":"21","author":"Horowitz MB","year":"2000","unstructured":"Horowitz MB, Purdy PD, Valentine RJ, Morrill K. \n                Remote vascular catastrophes after Neurovascular Interventional Therapy for Type 4 Ehlers-Danlos Syndrome \n                AJNR Am J Neuroradiol  \n                2000; \n                21\n                : 974-6.","journal-title":"AJNR Am J Neuroradiol"},{"key":"refR3","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1007\/BF02049321","volume":"37","author":"Berney T","year":"1994","unstructured":"Berney T, La Scala G, Vettorel D, et al. \n                Surgical pitfalls in a patient with type IV Ehlers-Danlos syndrome and spontaneous colonic rupture. 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