Traumatic Jejunal Injury in a Patient with Ehlers-Danlos Syndrome: A Case Report

Abstract

A 23-year-old man with a history of Ehlers-Danlos syndrome (EDS) was injured in a car accident and transported to our emergency medical center. Upon examination, he was diagnosed as having left-sided pneumothorax, multiple left-sided rib fractures, right lung contusion, and splenic injury. He was hospitalized for follow-up. However, 8 hours after the injury, he showed worsening abdominal pain and signs of peritoneal irritation. A second computed tomography revealed intestinal perforation and pan-peritonitis. Emergency laparotomy was performed, he was diagnosed as having a jejunal injury, and the intestinal perforation was closed with sutures. His postoperative course was favorable. He resumed water intake on the day 3 after surgery, resumed meal intake on day 5, and was discharged on day 12. Surgery and perioperative management require close attention in patients with EDS, because these patients are vulnerable to bleeding and rupture of their viscera. Additionally, the possibility of delayed intestinal perforation should not be ignored.