Conservative Management of Massive Retroperitoneal Hemorrhage in a Patient with Vascular Ehlers-Danlos Syndrome: A Case Report

Retroperitoneal hemorrhage in patients with vascular Ehlers-Danlos syndrome (vEDS) is uncommon, and its optimal management remains controversial because both surgical and endovascular interventions carry substantial risks. A 36-year-old man with vEDS presented with persistent upper abdominal pain. Computed tomography (CT) revealed a massive retroperitoneal hematoma, approximately 20 cm in size, with a pseudoaneurysm in a mesenteric artery branch but without contrast extravasation. Considering the potential complications associated with the intervention and the patient's overall stable hemodynamic condition, a conservative management approach under careful supervision was selected. A follow-up CT revealed a reduction in hematoma size, and the patient was discharged after 19 days of hospitalization without complications. Conservative management of retroperitoneal hemorrhage in patients with vEDS may be considered a viable option in hemodynamically stable conditions.