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Elhattabi K, Benghait H, Elbakouri A, Bouali M, Bensardi F, Fadil A. Total colectomy in Vascular Ehlers Danlos syndrome a case report and literature review. Ann Med Surg (Lond) 2021; 71:102948. [PMID: 34777791 PMCID: PMC8577335 DOI: 10.1016/j.amsu.2021.102948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction Ehlers Danlos syndromes (EDS) are a group of genetic disorders, characterized by skin hyperelasticity, joint hyperlaxity and tissue weakness. Vascular EDS is rare and is differs from other types of EDS by an inconsistent acrogenic morphotype and the occurrence of severe digestive and vascular complications, which can be lifethreatening. Case presentation We report the case of a 27-year-old man with a type IV vascular Ehlers-Danlos syndrome revealed by a colonic perforation after appendectomy for peritonitis secondary to appendicitis. The etiology of the perforation remained a challenge till a genetic research was carried out for COL3A1 gene mutation, which was positive in favor of vascular Ehlers Danlos disease. Then, a totalization of the colectomy with ileorectal anastomosis was performed. Discussion Vascular Ehlers Danlos syndrome (VEDS) is due to qualitative and quantitative abnormalities in the synthesis of type III collagen, which is a major constituent of the vessel wall, skin, joint capsules, uterus and gastrointestinal tract, particularly the colon. Colonic perforation, particularly sigmoidal perforation, is the most frequent complication in SEDV and most often precedes the molecular diagnosis. Colonic perforations are uncommon. The Hartmann procedure is a well-established surgical treatment modality, especially for emergency surgery. Given the iterative risk of colonic perforation and anastomotic leakage, preventive treatment by total colectomy with ileo-rectal anastomosis or definitive ileostomy is recommended by several authors. Conclusion SEDV is a rare pathology with a difficult diagnosis. However, it should be keeped in mind when there is any spontaneous colonic perforation in the young people. Ehlers danlos syndromes are a group of genetic disorders of the connective tissue. Life expectancy is reduced due to spontaneous vascular rupture or colonic perforation. Colonic perforations are uncommon. They occur in the context of diverticulitis in adults. The diagnosis is difficult because of the rarity of the pathology and the inaccessibility of genetic tests. The surgical management of colonic perforations in ehlers danlos syndromes is not codified.
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Affiliation(s)
- Khalid Elhattabi
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Hasna Benghait
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelilah Elbakouri
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mounir Bouali
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
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Lahlou Laforêt K. Le risque vital associé aux maladies vasculaires rares : l’expérience du psychiatre de liaison. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2013.09.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Le centre national de référence des maladies rares (HEGP) réunit des compétences multidisciplinaires permettant la centralisation des soins pour les patients atteints de six pathologies vasculaires rares. L’une de ces pathologies, le Syndrome d’Ehlers-Danlos vasculaire (SEDv), présente une gravité particulière en raison de la fragilité des parois artérielles liée à un défaut du collagène. Les complications (anévrysmes, dissections ou ruptures) peuvent engager le pronostic vital ou fonctionnel immédiat, avec un début à l’âge de jeune adulte. Le SEDv est une maladie héréditaire dont la transmission est autosomique dominante. Le test génétique (mutation du gène Col 3 A1) confirme le diagnostic chez les patients atteints et permet de dépister les apparentés. Le mode évolutif de la pathologie, émaillé de complications souvent sévères, entrecoupées de périodes plus ou moins longues de bonne santé, est un paradigme d’adaptation à l’incertitude. Comment dépasser le traumatisme d’un accident vasculaire alors que d’autres sont annoncés avec une certaine probabilité ? Un certain nombre de mesures préventives constituent des repères rassurants pour les patients, tels que la prise d’un bêtabloquant, l’évitement d’activités physiques intenses et les précautions prises lors des actes chirurgicaux. L’appropriation de cette pathologie et de ses conséquences est diverse selon les patients et selon les étapes qu’ils traversent, entre une prudence extrême, les empêchant de vivre, et une prise de risques, en particulier chez les sujets jeunes, pouvant les mettre en danger. Le psychiatre de liaison, par son écoute et ses interventions, participe à la dédramatisation de l’incertitude, contribue à l’implication du patient dans le projet de soins, et aide l’équipe à faire face à des moments de crise. Il permet aussi de réfléchir aux procédures d’annonce dans des familles où parfois plusieurs décès en relation avec la même pathologie ont eu lieu : une temporalité personnalisée tenant compte des particularités de ces familles peut ainsi prévenir ou du moins atténuer l’impact traumatique de ce type d’annonce.
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Mazzella JM, Adham S, Frank M, Legrand A, Lahlou-Laforêt K, Jeunemaitre X. Communication of genetic information to at-risk relatives during the multidisciplinary monitoring of vascular Ehlers-Danlos syndrome in a French referral clinic. J Genet Couns 2020; 29:828-837. [PMID: 31903687 DOI: 10.1002/jgc4.1211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 11/10/2022]
Abstract
Vascular Ehlers-Danlos syndrome (vEDS) is a rare inherited disorder leading to arterial, digestive, and uterine complications due to pathogenic COL3A1 variants. Identification of causal variants allows family screening, provided that relatives have previously been informed, according to a 2013 French Decree. The aims of our study were to assess the communication of genetic information to at-risk relatives, the impact of diagnosis disclosure and to highlight a possible link between the experience of vEDS patients and ability to communicate about genetic information. A total of n = 51 vEDS adult probands answered a questionnaire during a clinical visit. Communication to relatives was considered effective if the proband gave information to some or all first-degree relatives and considered easily achieved if it was disclosed to all relatives less than a month after the diagnosis and without difficulty. Personal and family vEDS experiences of probands were also assessed. Effective communication of information to relatives was remarkably high (98%). Siblings were the most frequently informed relatives (82%). Women informed their at-risk relatives of genetic family screening faster (p = .006) and easier (p = .004) than men. There was no difference in the disclosure of information to relatives before and after 2013 in our multidisciplinary clinic. Regarding the lived experience of vEDS patients, they felt anxious (78%) at diagnosis disclosure but also considered this diagnosis as an opportunity to start a medical follow-up (82%) putting an end to diagnosis delay. Our findings highlight for the first time that the ability to easily inform at-risk first-degree relatives is related to the relief felt during vEDS-positive diagnosis disclosure (p = .04). In order to improve the communication of genetic information to relatives, we believe that psychological support should systematically be part of the multidisciplinary monitoring, just as medical follow-up and genetic counseling.
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Affiliation(s)
- Jean-Michaël Mazzella
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Salma Adham
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Michael Frank
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,INSERM, U970, Paris centre de Recherche Cardiovasculaire - PARCC, Paris, France
| | - Anne Legrand
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM, U970, Paris centre de Recherche Cardiovasculaire - PARCC, Paris, France
| | - Khadija Lahlou-Laforêt
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Unité de Psychologie et Psychiatrie de Liaison et d'Urgence, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Xavier Jeunemaitre
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM, U970, Paris centre de Recherche Cardiovasculaire - PARCC, Paris, France
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Mazzella JM, Frank M, Collignon P, Langeois M, Legrand A, Jeunemaitre X, Albuisson J. Phenotypic variability and diffuse arterial lesions in a family with Loeys-Dietz syndrome type 4. Clin Genet 2016; 91:458-462. [PMID: 27440102 DOI: 10.1111/cge.12838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 01/20/2023]
Abstract
Syndromic thoracic aortic aneurysm and dissection (TAAD) can suggest Marfan, vascular Ehlers-Danlos or Loeys-Dietz (LDS) syndromes. Several of the TGFβ-pathway-related genes predispose to different types of LDS. Heterozygous loss-of-function variations in TGFβ2 have been shown to be responsible for a novel form of syndromic TAAD associated with an impairment of the mitral valve and cerebrovascular disease called Loeys-Dietz syndrome type 4 (LDS4). We report the clinical characterization of a LDS4 French family with sudden deaths and diffuse vascular lesions, caused by a frameshift mutation in TGFβ2 gene: c.[995del]; p.(Leu332TrpfsTer27). Clinical characteristics include aneurysm of aortic sinus, skeletal and cutaneous features compatible with a syndromic form of TAAD (joint hypermobility, scoliosis, and easy bruises), intracranial aneurysms and rare mitral valve involvement. Iliac aneurysms, systemic medium caliber arteries dissections, and mild developmental delay were present in the family, and have not been described in LDS4. Phenotypic variability was also an important finding, including absence of clinical vascular events at advanced age in one case. Our data expand the phenotype of LDS4: we confirm that TGFβ2 mutations are responsible for true LDS syndrome with non-specific features of connective tissue disorders and diffuse vascular lesions. Adapted vascular follow up and prevention has to be proposed for these patients.
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Affiliation(s)
- J-M Mazzella
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France
| | - M Frank
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France
| | - P Collignon
- Centre Hospitalier Intercommunal Toulon-La Seyne-sur-Mer, Service de Génétique Médicale, Toulon, France
| | - M Langeois
- Centre de Référence National Syndromes de Marfan et apparentés, Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - A Legrand
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Paris Cardiovascular Research Centre, INSERM, U970, Paris, France
| | - X Jeunemaitre
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Paris Cardiovascular Research Centre, INSERM, U970, Paris, France
| | - J Albuisson
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Paris Cardiovascular Research Centre, INSERM, U970, Paris, France
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Daghfous A, Bouzaidi K, Rezgui Marhoul L. [Spontaneous isolated dissection of the superior mesenteric artery: an uncommon cause of acute abdomen. A case report]. Rev Med Interne 2014; 36:131-4. [PMID: 24630867 DOI: 10.1016/j.revmed.2013.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 09/13/2013] [Accepted: 11/22/2013] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Isolated spontaneous dissection of the superior mesenteric artery is the most common digestive artery dissection. It is a rare cause of acute abdomen. Only a few hundred cases have been reported in the literature. CASE REPORT We report a 40-year-old man with a past medical history of high blood pressure who presented abdominal pain that was related to a spontaneous dissection of the superior mesenteric artery. Computed tomography revealed an isolated dissection of superior mesenteric artery. There were no evidence of bowel ischemia. We decided a conservative treatment and the outcome was favorable, without recurrent symptoms or disease progression. CONCLUSION Based on this case report, we discuss the etiology of this vascular lesion and the contribution of computed tomography in the diagnosis, the therapeutic strategy and the follow-up of spontaneous dissection of superior mesenteric artery.
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Affiliation(s)
- A Daghfous
- Service d'imagerie médicale, centre traumatologie et des grands brûlés de Tunis, avenue du Grand Maghreb, Nabeul 8000, Tunisie.
| | - K Bouzaidi
- Service d'imagerie médicale, hôpital MT Maâmouri, Nabeul, Tunisie
| | - L Rezgui Marhoul
- Service d'imagerie médicale, centre traumatologie et des grands brûlés de Tunis, avenue du Grand Maghreb, Nabeul 8000, Tunisie
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de Gennes C, Leata C, Oliviero G, Régnard JF, Blivet S, Carpentier MC, Colby T, Bouillet L, Jeunemaitre X. Un trou peut en cacher un autre. Rev Med Interne 2014; 35:68-72. [DOI: 10.1016/j.revmed.2013.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 05/27/2013] [Indexed: 12/01/2022]
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7
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Okada T, Frank M, Pellerin O, Primio MD, Angelopoulos G, Boughenou MF, Pagny JY, Messas E, Sapoval M. Embolization of Life-Threatening Arterial Rupture in Patients with Vascular Ehlers–Danlos Syndrome. Cardiovasc Intervent Radiol 2013; 37:77-84. [DOI: 10.1007/s00270-013-0640-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Accepted: 04/03/2013] [Indexed: 10/26/2022]
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8
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[Bilateral spontaneous carotid-cavernous fistula revealing Ehler-Danlos disease]. Ann Dermatol Venereol 2013; 140:296-9. [PMID: 23567233 DOI: 10.1016/j.annder.2012.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 11/22/2012] [Indexed: 10/27/2022]
Abstract
PATIENTS AND METHODS A 34-year-old woman with an extensive surgical history developed two spontaneous carotido-cavernous fistula bilaterally. Skin examination revealed an acrogeric form of vascular Ehlers-Danlos syndrome and this diagnosis was confirmed by genetic analysis. DISCUSSION Vascular Ehlers-Danlos syndrome is a rare autosomal dominant genetic disease that may be suspected on the grounds of clinical symptoms. Severe complications can occur in early life and are associated with a high mortality rate. The prognosis of vascular Ehlers-Danlos syndrome has been radically changed by the use of beta-blockers. CONCLUSION The originality of our observation lies in the long time to onset of the initial complications in the absence of any problems during the numerous operations undergone by the patient, as well as the two childbirths.
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Jamard A, Le Hello C, Simonet T, Dreyfus M. [Vascular Ehlers-Danlos syndrome and pregnancy: an obstetrical specific support]. JOURNAL DE GYNECOLOGIE, OBSTETRIQUE ET BIOLOGIE DE LA REPRODUCTION 2012; 41:676-8. [PMID: 22522144 DOI: 10.1016/j.jgyn.2012.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 01/04/2012] [Accepted: 01/23/2012] [Indexed: 10/28/2022]
Abstract
The Ehlers-Danlos syndrome (EDS) is a rare inheritable disease, characterised by a defect in collagen synthesis. Various types have been described and the type IV or vascular type is the most severe characterised by vascular, gastrointestinal and gynaecologic complications. We describe in a case report the specific obstetrical support we applied to avoid the most frequent complications such as early spontaneous abortions, pre-term delivery, tearing of perineum, uterine and vascular rupture and hard healing. Pregnancy is very risky in women with vascular EDS. Combination of multidisciplinary support and advice of the rare vascular disease national reference centre may reduce the morbi-mortality rate, including celiprolol long-term treatment.
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Affiliation(s)
- A Jamard
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Caen-FEH, Caen cedex, France.
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De-Giorgio F, Grassi VM, Vetrugno G, Arena V. Commentary on: Shields LB, Rolf CM, Davis GJ, Hunsaker JC 3rd. Sudden and unexpected death in three cases of Ehlers-Danlos syndrome type IV. J Forensic Sci 2010;55(6):1641-5. J Forensic Sci 2011; 56:1395-6; author reply 1397. [DOI: 10.1111/j.1556-4029.2011.01857.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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11
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Pepin M, Byers PH, Shields LB, Rolf CM, Davis GJ, Hunsaker JC. Authors’ Response. J Forensic Sci 2011. [DOI: 10.1111/j.1556-4029.2011.01856.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Sudden death associated to vascular Ehlers–Danlos syndrome. A case report. Leg Med (Tokyo) 2011; 13:145-7. [DOI: 10.1016/j.legalmed.2010.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 10/07/2010] [Accepted: 12/19/2010] [Indexed: 11/19/2022]
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13
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Maladies Vasculaires de L'enfant Hors Malformations. TRAITÉ DE MÉDECINE VASCULAIRE. 2011. [PMCID: PMC7151922 DOI: 10.1016/b978-2-294-71346-0.50037-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Azghari A, Bouayad M, Belmir H, Tijani Y, Bouziane Z, Idrissi R, El Mahi O, Lekehal B, Sefiani Y, El Mesnaoui A, Ammar F, Bensaid Y. Syndrome d’Ehlers-Danlos de type vasculaire : une cause rare de faux-anévrismes artériels spontanés. ACTA ACUST UNITED AC 2010; 35:254-8. [DOI: 10.1016/j.jmv.2010.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Accepted: 03/11/2010] [Indexed: 10/19/2022]
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Guyot E, Carillion A, Poli-Merol ML, Ferrand I, Amory C, Chaoudi D, Poret S, Malinovsky JM. Ehlers–Danlos syndrome type IV in a child admitted in emergency with peritonitis. Br J Anaesth 2009; 103:615-6. [DOI: 10.1093/bja/aep249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vera Artázcoz A, Julia Montoya J, Lozano Vilardell P. Rotura espontánea de arteria femoral en paciente afecto de Ehlers-Danlos tipo IV o Sacks-Barbara. Cir Esp 2009; 86:182-4. [DOI: 10.1016/j.ciresp.2008.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2008] [Accepted: 01/29/2008] [Indexed: 10/20/2022]
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Mandeville K, Bicknell C, Tran T, MacDermot K, Renton S. Pseudoaneurysm of the Peroneal Artery: Presentation of Ehlers-Danlos Syndrome Type IV. Eur J Vasc Endovasc Surg 2008; 36:353-5. [DOI: 10.1016/j.ejvs.2008.02.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Accepted: 02/23/2008] [Indexed: 11/26/2022]
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Fèvre MC, Falcon D, Jouk PS, Seinturier C, Jacquot C. [Vascular Ehlers-Danlos syndrome: a clinical syndrome to be known by every anaesthesiologist and intensive care physician]. ACTA ACUST UNITED AC 2007; 27:90-3. [PMID: 18068944 DOI: 10.1016/j.annfar.2007.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Accepted: 10/22/2007] [Indexed: 10/22/2022]
Abstract
We report the case of a 29-year-old female who presented with a series of major vascular complications in rapid succession: haemothorax following rupture of a mammary artery aneurysm, pulmonary embolism, anterior myocardial infarction secondary to spontaneous dissection of the left anterior descending artery and rupture of a false aneurysm of the splenic artery. A diagnosis of Ehlers-Danlos syndrome (vascular variant) was considered the most likely in this context. Characterized by an extreme vascular fragility, this rare disease poses important clinical management issues for the anaesthetist and intensive care physician.
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Affiliation(s)
- M-C Fèvre
- Service de réanimation chirurgicale et polyvalente, CHU Albert-Michallon, B.P. 217, 380432 La Tronche cedex 09, France
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Bibliography. Current world literature. Laryngology and bronchoesophagology. Curr Opin Otolaryngol Head Neck Surg 2007; 15:417-24. [PMID: 17986882 DOI: 10.1097/moo.0b013e3282f3532f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Maisonneuve H, Chabot O. Un texte court dans la revue et un texte long sur l’Internet pour contenter lecteurs et auteurs. Presse Med 2006; 35:1860-2. [PMID: 17159711 DOI: 10.1016/s0755-4982(06)74918-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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