title: Gynecologic and surgical complications in type IV Ehlers-Danlos syndrome.
abstract: BACKGROUND
  Although type IV Ehlers-Danlos syndrome is a rare condition, it is critical that physicians be aware of this disease because it presents unique management challenges.
  
  
  METHODS
  We present a young woman who was admitted with a pelvic abscess after having a miscarriage and an appendiceal perforation. She had an exploratory laparotomy secondary to a persistent pelvic abscess and endured multiple postoperative complications. Based on her family history and physical characteristics, type IV Ehlers-Danlos syndrome was diagnosed.
  
  
  CONCLUSIONS
  The decision to proceed with surgery should be weighed against tissue fragility in patients with type IV Ehlers-Danlos syndrome. A conservative, multidisciplinary team approach addresses whether to proceed with surgery and minimize postoperative complications if surgery is performed.
authors.affiliation: Departments of Obstetrics and Gynecology and Genetics and the School of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Sarahn M
authors.initials: SM
authors.lastname: Wheeler
authors.forename: Melissa
authors.initials: M
authors.lastname: Russo
authors.forename: Molly
authors.initials: M
authors.lastname: Wilson-Murphy
authors.forename: Wen
authors.initials: W
authors.lastname: Shen
mesh_terms: D000038:Abscess / Q000209:etiology*; D000328:Adult; D001064:Appendicitis / Q000601:surgery*; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D034161:Pelvic Infection / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000601:surgery*