RESUMO
Introduction: Rectus sheath haematoma (RSH) has become increasingly common but is often underdiagnosed. Prompt diagnosis will avoid unnecessary investigations and procedures, resulting in early treatment and a better outcome. Case description: We described a case of a spontaneous RSH with intraperitoneal extension and formation of a vesico-haematoma fistula, which was initially misdiagnosed as a urinary tract infection. The diagnosis was made ten days after admission, when a CT scan showed an over-16 cm RSH with intraperitoneal extension, bladder perforation and a vesico-haematoma fistula. The patient was managed conservatively. Discussion: RSH accounts for less than 2% of acute abdomen cases and is often unrecognised. Its presentation can mimic other intra-abdominal pathologies, and the diagnosis is often delayed or missed. Complications can arise from an RSH although it is generally viewed as a self-limiting condition. Conclusion: RSH has become increasingly common, and we would like to highlight the need to include abdominal wall pathologies in the initial differential diagnoses of acute abdomen to avoid delay in diagnosis. LEARNING POINTS: Rectus sheath haematoma has become increasingly common due to the use of anticoagulants.The presentation can be non-specific and mimic other intra-abdominal pathologies. Misdiagnosis or delayed diagnosis can result in complications and unnecessary invasive procedures.Abdominal wall pathologies including rectus sheath haematomas should be included in initial differentials of acute abdomen.
RESUMO
To explore the characteristics of carbon and nitrogen stable isotope and trophic niche between two forms (medium-form and dwarf-form) of the purple flying squid Sthenoteuthis ouala-niensis, we collected samples from the central and western South China Sea in August 2017 to analyze the values of carbon and nitrogen stable isotope and the changes of trophic level for different mantle lengths. We further compared the trophic niche differences of the two forms populations. The results showed that for the medium-form, the δ13C value ranged from -19.54 to -18.10 and the δ15N value ranged from 7.79 to 9.45. The average trophic level of medium-form was 2.90 and ranged from 2.72 to 3.21. For the dwarf-form, the δ13C value ranged from -19.69 to -18.43, and the δ15N value ranged from 8.02 to 8.99. The average trophic level of the dwarf-form was 2.91 and ranged from 2.79 to 3.08. There were significant differences of δ15N but no differences of δ13C values between the medium-form and dwarf-form of purple flying squid. The mantle length had a significant impact on δ13C and δ15N, with the value of δ15N increasing with the mantle length. The trophic niche breadth and the trophic level of the medium-form purple flying squid were more diverse than those of dwarf-form.
