Abstract
Herein, we report a case of Ehlers-Danlos syndrome (EDS) presenting with multiple small intestine diverticula, possibly caused by adhesive small bowel obstruction, after vascular surgery. A man in his 50s underwent a surgical procedure for inferior vena cava filter deviation. One week after the operation, abdominal CT showed dilated small bowel segments and free air in the abdomen : gastrointestinal perforation was suspected and emergency surgery was performed. During the operation, a small intestinal stenosis was found in an adherent part of the intestine under the last operative wound. As a result of the stenosis, the proximal side of the small intestine was dilated, with the formation of multiple diverticula. One of the diverticula penetrated the mesentery, causing inflammation. Small intestinal resection and anastomosis were risky because of the weakness of the tissue associated with EDS. Adhesiolysis for the small bowel obstruction and decompression of the small intestine with an ileus tube were performed. EDS type IV is characterized by a decrease in type III collagen, which reduces the tissue tolerance to pressure of tissues. In this case, the intestinal tissue expanded with the formation of multiple diverticula, presumably because of the poor tolerance to pressure associated with the lack of type III collagen.
