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\langfe2052 \langfenp2052 \cf3 1}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf3 . HEMANGIOMUL
INFANTIL}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\langfe2052 \langfenp2052 \par }\pard \plain \li0 \ri0 \lisb0 \sa200 \lisa0
\nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24 \kerning1 \dbch \af2 \hich \af0
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\b1 \fs26 \kerning1
\cf1 Aspecte clinice}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li0 \ri0 \lisb0 \lisa0
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\fs26 \kerning1
\cf1 Leziunile interne si viscerale sunt rare.
20% din pacienti pot avea tumori multiple; pot prezenta hemangioame interne la
nivelul ficatului, tractului gastrointestinal si creierului.}{\fs24 \kerning1 \dbch
\af2 \hich \af0 \loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052
\par }\pard \plain \li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0
\itap0 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033 \langnp1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Complicatii locale}{\fs26
\langfenp2052 \cf1 : }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf8 Ulceratie}{\b1 \fs24 \kerning1
\cf8 \par }\pard \plain \li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0
\rin0 \itap0 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033 \langnp1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf8 Hemoragie}
\langfe2052 \langfenp2052 \cf8 \par }\pard \plain \li0 \ri0 \lisb0 \lisa0
\cf8 Necroza}{\b1 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf8 \par }\pard \plain \li0
\ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24 \kerning1
\langfe2052 \langfenp2052 \cf1 \par }\pard \plain \fi-420 \cufi0 \li420 \culi0 \ri0
\lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin420 \rin0 \jclisttab \tx420
\af2 \hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f3
l\'00\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 Leziunile regiunii cervico-faciale}
\langfe2052 \langfenp2052 \cf1 ->}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf8 obstructia cailor
aeriene}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 prin cresterea din faza proliferativa}{\fs24
\langfenp2052 \par }\pard \plain \fi-420 \cufi0 \li420 \culi0 \ri0 \lisb0 \lisa0
\pnrnot0 \nowidctlpar \hyphpar0 \lin420 \rin0 \jclisttab \tx420 \itap0 \ls3
\hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f3 l\'00\tab
\langfe2052 \langfenp2052 \cf1 Leziunile faciale}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -> }{\b1
\langfe2052 \langfenp2052 \cf8 necroza tisulara}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 cu
consecinte cosmetice (cand sunt implicate pleoapele,nasul, buzele sau urechile)}
\langfe2052 \langfenp2052 \par }\pard \plain \fi-420 \cufi0 \li420 \culi0 \ri0
l\'00\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 Hemangioamele foarte mari}{\fs26
\langfenp2052 \cf1 pot duce la }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf8 insuficienta
cardiaca cu debit crescut }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 secundara fluxului crescut si
suntarii vasculare de la nivelul tumorii}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 .}{\fs24
\pnrnot0 \nowidctlpar \hyphpar0 \lin420 \rin0 \jclisttab \tx420 \itap0 \ls3
\hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f3 l\'00\tab
\langfe2052 \langfenp2052 \cf1 Hemangioamele gastrointestinale}{\fs26 \kerning1
\cf1 sunt foarte rare -> }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf8 hemoragii gastrointestinale}
\langfe2052 \langfenp2052 \cf1 .}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li0 \ri0
\lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24 \kerning1 \dbch
\af2 \hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\b1
\cf1 Diagnostic imagistic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li0 \ri0 \lisb0
\lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24 \kerning1 \dbch \af2
\langfenp2052 \cf1 }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Ecografia }{\fs26
\langfenp2052 \cf1 si in special }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 rezonanta magnetica
}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052
\langfenp2052 \cf1 sunt principalele instrumente imagistice de diagnostic.}
\langfe2052 \langfenp2052 \par }\pard \plain \li0 \ri0 \lisb0 \lisa0
\cf1 Ecografia hemangioamelor \uc1 \u238 ?n faza proliferativa arata o }
\langfe2052 \langfenp2052 \cf1 \ul1 masa}{\fs24 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \ul1 \par }\pard
\plain \li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24
\langnp2057
\langfe2052 \langfenp2052 \cf1 \ul1 cu parenchim dens}{\fs26 \kerning1 \dbch
si }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 \ul1 vascularizatie cu flux crescut}{\fs26 \kerning1
\cf1 , diferentiind hemangioamele infantile profunde de malformatiile venoase ce au
flux sanguin redus}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfe2052 \langfenp2052 \cf3 2. HEMANGIOMUL CONGENITAL}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Tumori vasculare benigne rare}
\cf1 Prezente inca de la nastere,dimensiuni mari}{\fs24 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard
\langnp2057 \langfe2052 \langfenp2052 \cf1 Leziuni cutanate localizate la nivelul
capului, gatului sau al membrelor}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\cf1 Doua subtipuri:}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 1 Hemangioame congenitale ce}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 involueaza rapid}
\cf1 -Involueaza complet pana la varsta de 14 luni.}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 2 Hemangioame congenitale ce}
\langfe2052 \langfenp2052 \cf1 nu involueaza}{\b1 \fs24 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard
\langnp2057 \langfe2052 \langfenp2052 \cf1 -Pot creste in dimeniuni o data
cu cresterea pacientului.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 -Necesita excizie chirurgical}{\fs26 \kerning1 \dbch
\u259 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057
\cf3 3. ANGIOBLASTOMUL SI HEMANGIOENDOTELIOMUL KAPOSIFORM}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \par }\pard \plain \fi-425
\cufi0 \li1265 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0
\lin1265 \rin0 \tql \tx425 \itap0 \ls4 \fs24 \kerning1 \dbch \af2 \hich \af0
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\listtext \pard
\plain \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033 \langnp1033
\langfe2052 \langfenp2052 \f2 1.\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Aceste tumori
vasculare ale copilariei sunt mai agresive si invazive decat hemangioamele
infantile.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi-425 \cufi0 \li1265
\culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin1265 \rin0 \tql
\tx425 \itap0 \ls4 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033
2.\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 Prezente inca de la nastere}{\fs24 \kerning1
\par }\pard \plain \fi-425 \cufi0 \li1265 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 3.\tab }{\fs26 \kerning1
\cf1 Leziuni unice}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin1265 \rin0 \tql
\tx425 \itap0 \ls4 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033
\langfe2052 \langfenp2052 \cf1 Macule eritematoase}{\fs24 \kerning1 \dbch \af2
\langfenp2052 \cf1 HEK este o tumora mai extinsa cu zone tegumentare rosu-
violacee si echimoze perilezionale.Imagistica HEK arata o leziune intensa cu
margini imprecis definite care se extinde printre planurile tisulare.}{\fs24
\langfenp2052 \par }\pard \plain \li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0
\lin0 \rin0 \itap0 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \par }\pard
\langnp2057 \langfe2052 \langfenp2052 \cf1 Fenomenul Kasabach-Merritt}{\fs24
\langfenp2052 \par }\pard \plain \fi-360 \li720 \ri0 \lisb0 \lisa0 \nowidctlpar
\af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\listtext \pard \plain
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Trombocitopenie
severa, petesii si hemoragie asociate unui hemangiom gigant}{\fs24 \kerning1
\par }\pard \plain \fi-360 \li720 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin720
\langfe2052 \langfenp2052 \cf1 Singurele asocieri cunoscute sunt cu angioblastomul
si HEK}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\langfe2052 \langfenp2052 \par }\pard \plain \fi-360 \li720 \ri0 \lisb0 \lisa0
\hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\listtext
\pard \plain \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033 \langnp1033
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Nivel scazut
fibrinogen}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi-360 \li720 \ri0 \lisb0
\lisa0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls5 \fs24 \kerning1 \dbch
\cf1 Timp protrombina si timp de tromboplastin usor crescute}{\fs24 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 Nivel crescut D-dimeri}{\fs24 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 Anemie hemolitica.}{\fs24 \kerning1 \dbch \af2 \hich
\langfenp2052 {\fs40 \kerning1 \dbch \af2 \hich \af0 \loch \f9 \lang9 \langnp9
\dbch \af2 \hich \af0 \loch \f9 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf3
Hernia Diafragmatica}{\fs40 \kerning1 \dbch \af2 \hich \af0 \loch \f9 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf3 -}{\b1 \fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Diagnostic
Pozitiv}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
Diagnostic prenatal}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \par
}\pard \plain \fi-360 \cufi0 \li720 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Polihidramios}{\fs24
\pnrnot0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls6 \fs24 \kerning1 \dbch
\dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Este
posibil la ecografia morfologica fetala in 15% din cazuri incepand din saptamana
16.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls6 \fs24
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 3.\tab }{\fs26
\kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052
\cf1 Masa toracica ecogena cu prezenta anselor intestinale in torace,}{\fs24
Deplasarea controlaterala a mediastinului,}{\fs24 \kerning1 \dbch \af2 \hich
\plain \fi-360 \cufi0 \li720 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Absenta bulei gastrice din
abdomen sau/si prezenta ei in torace,}{\fs24 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi-
360 \cufi0 \li720 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin720
\langfe2052 \langfenp2052 \cf1 Ficat situat in torace, greu de diferentiat de
plaman datorita ecogenitatii asemanatoare}{\fs24 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang1033 \langnp1033
\cf1 RMN poate aduce precizari asupra pozitiei ficat}{\fs24 \kerning1 \dbch \af2
Diagnostic Pozitiv}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
}\pard \plain \li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Clinic}{\fs24 \kerning1 \dbch
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \par }\pard \plain \fi-420 \cufi0
\li420 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin420 \rin0
\jclisttab \tx420 \itap0 \ls7 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5
\lang1033 \langnp1033 \langfe2052 \langfenp2052 {\listtext \pard \plain \fs24
\langfenp2052 \f3 l\'00\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Nounascutul prezinta detresa
respiratorie la nastere sau in primele 24h cu dispneee tahipnee cianoza in
afebrilitate.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin420 \rin0
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 La inspectie hemitorace stang marit
de volum cu abdomen escavat, tiraj intercostal}{\fs24 \kerning1 \dbch \af2 \hich
\hyphpar0 \lin420 \rin0 \jclisttab \tx420 \itap0 \ls7 \fs24 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \f3 l\'00\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 La percutie matitate
cardiaca impinsa spre dreapta, alternanta de matitate si hipersonoritate in
toracele stang}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 La auscultatie deplasarea zgomotelor
cardiace in dreapta zgomote hidroaerice in stanga.}{\fs24 \kerning1 \dbch \af2
\hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\b1 \fs26
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 La radiografia toracoabdominala in
picioarese se observa:}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi-360
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 {\uc1
\u65399 ?}0\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9
\langnp9 \langfe2052 \langfenp2052 \cf1 Orizontalizarea coastelor pe stanga}
\langfe2052 \langfenp2052 \f2 {\uc1 \u65399 ?}1\tab }{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 (partea
leziunii)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Imagini
hidroaerice in torace}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 {\uc1 \u65399 ?}3\tab }
{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052
\langfenp2052 \cf1 Cord impins retrosternal pana in dreapta}{\fs24 \kerning1
{\uc1 \u65399 ?}4\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9
\langnp9 \langfe2052 \langfenp2052 \cf1 Abdomen cu aerare redusa}{\fs24
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Daca se decide
si se efectueaza irigografie se poate demonstra prezenta colon in torace.}{\fs24
\lin0 \rin0 \itap0 \fs24 \kerning1 \dbch
\langfenp2052 \cf1 \par }\pard \plain \li0 \ri0 \lisb0 \lisa0 \nowidctlpar
\hyphpar0 \lin0 \rin0 \itap0 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5
\lang1033 \langnp1033 \langfe2052 \langfenp2052 {\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \par }\pard
Atrezia de esofag}{\fs32 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
Clasificare}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li360 \culi0 \ri0
\langfenp2052 \cf1 Tip 3 - Atrezie esofagiana cu fistula esotraheala distala e cea
mai frecventa reprezinta 86% din total. Capatul proximal e inchis in deget de
manusa si este dilatat capatul distal comunica prin fistula cu traheea si de aceea
abdomenul este aerat. Acesta este subtire hipoplazic. Distanta intre capete permite
in generalanastomoza si repararea primara.}{\fs24 \kerning1 \dbch \af2 \hich
\plain \li360 \culi0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin360 \rin0 \itap0
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Tip 1 - Atrezia de esofag fara
fistula esotraheala, incidenta este de 7%, abdomenul nu e aerat iar diatanta intre
cele doua capete e mare si nu permite anastomoza}{\fs24 \kerning1 \dbch \af2
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Tip 2 - Atresia esofagiana cu
fistula pe capul proximal are o incidenta de 2%,abdomenul este neaerat. Distanta
intre capete este variabila}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li360 \culi0
\ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin360 \rin0 \itap0 \ls0 \fs24 \kerning1
\langfenp2052 \cf1 Tip 4 - Atrezia esofagiana cu fistule pe ambele capete este cea
mai rara <1% abdomenul este hiperaerat si distanta intre capete poate permite
anastomoza.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li360 \culi0 \ri0
\langfenp2052 \cf1 Tip 5 - FISTULA ESOTRAHEALA IZOLATA}{\fs24 \kerning1 \dbch
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Este foarte rara,
esofagul prezinta lumen normal dar exista o comunicare anormala cu traheea sub
forma unei fistule situate deobicei la nivelul C5-C6 sau T3-T4.}{\fs24 \kerning1
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \par }\pard \plain \li0 \ri0
\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052
\lang1033 \langnp1033 \langfe2052 \langfenp2052 {\b1 \fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Diagnostic
prenatal}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Dupa saptamana 18 se evidentiaza}
}\pard \plain \fi-360 \li720 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin720
\langnp9 \langfe2052 \langfenp2052 \cf1 Polihidramios}{\fs24 \kerning1 \dbch
\langnp9 \langfe2052 \langfenp2052 \cf1 Bula gastrica redusa sau absenta}{\fs24
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Se poate
observa esofagul proximal dilatat.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Clinic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\cf1 \par }\pard \plain \fi-360 \li720 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0
\lin720 \rin0 \itap0 \ls8 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5
\lang1033 \langnp1033 \langfe2052
\langnp9 \langfe2052 \langfenp2052 \cf1 Nounascutul este de obicei prematur}
\langfe2052 \langfenp2052 \f2 {\uc1 \u65399 ?}10\tab }{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Prezinta
hipersalivatie prin imposibilitatea de a inghiti saliva care se exteriorizeaza ca o
sputa aerate.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfenp2052 \cf1 Saliva se acumuleaza in capatul proximal de unde se intoarce in
faringe de unde poate fi aspirata.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langnp9 \langfe2052 \langfenp2052 \cf1 La incercarea de introducere a unei sonde
nasogastrice aceasta se opreste la 8-10cam de arcada gingivala sau se poate
incolaci si intoarce in gura.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langnp9 \langfe2052 \langfenp2052 \cf1 Acumularea de saliva sau tentative de
alimentare provoaca nounascutului tuse si cianoza care cedeaza dupa aspiratiea
secretiilor.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 La
auscultatie prezinta ronchusuri pulmonare.}{\fs24 \kerning1 \dbch \af2 \hich
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Diagnosticul pozitiv}{\fs24
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Imagistic}{\fs24 \kerning1
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \par }\pard \plain \fi-360 \li720
\ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls8 \fs24 \kerning1
\langfenp2052 \cf1 La radiografia toraco-abdominala daca sa montat o sonda radio-
opaca se poate observa cum aceasta se opreste la nivelul mediastinului superior.}
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Pe sonda
se poate introduce aer iar capatul proximal devine atunci hipertransparent sau
substanta de contrast si atunci acesta se opacifiaza.}{\fs24 \kerning1 \dbch
\langnp9 \langfe2052 \langfenp2052 \cf1 Cavitatea abdominala este aerata dupa cum
exista sau nu fistula pe capatul distal.}{\fs24 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain
\li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24
\langfenp2052 \cf3 HERNIA HIATALA si REFLUXUL GASTROESOFAGIAN}{\fs28 \kerning1
\langfenp2052 \cf1 Diagnostic pozitiv}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp9 \langfe2052 \langfenp2052 \cf1 Clinic}{\fs24 \kerning1 \dbch \af2 \hich
\hyphpar0 \lin420 \rin0 \jclisttab \tx420 \itap0 \ls9 \fs24 \kerning1 \dbch \af2
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 In ambele afectiuni apar
semnele clasice de }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9
\langnp9 \langfe2052 \langfenp2052 \cf14 reflux pirozis regurgitatii dureri
epigastrice cu character de arsura cu iradiere retrosternala}{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 .}
l\'00\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 Nou nascutul nu poate relata durerea \uc1 \u8211 ?
ea determina refuzul alimentatiei,}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 agitatie,
somn superficial de scurta durata}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi-420
\cufi0 \li420 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin420
\rin0 \jclisttab \tx420 \itap0 \ls9 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Apar frecvent varsaturi
mai mult sau mai putin importante care fac dificila}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }
\langfenp2052 \cf1 alimentarea. Acestea pot fi cu striuri de sange o data cu
instalarea esofagitei}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 de}{\fs26 \kerning1
\cf1 }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052
\langfenp2052 \cf1 reflux}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 .}{\fs24 \kerning1 \dbch
\nowidctlpar \hyphpar0 \lin420 \rin0 \jclisttab \tx420 \itap0 \ls9 \fs24
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f3 l\'00\tab }{\fs26
\cf1 In hernia hiatala apar si semen provocate de volumul herniei, dispnee
nocturna}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 sau paroxistica, tuse spastica
in decubit dorsal, aritmi si durere de tip anginos,}{\fs26 \kerning1 \dbch \af2
\langfenp2052 \cf1 sughit incoercibil.}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs24 \kerning1
\nowidctlpar \hyphpar0 \lin420 \rin0 \jclisttab \tx420 \itap0 \ls9 \fs24
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f3 l\'00\tab }{\fs26
\cf1 In refluxul gastro esofagian un semn indirect il reprezinta episoadele
recurente}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057
\f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 de spasm bronsic provocat de
aspirarea refluxului acid. De aceea copii cu crize}{\fs26 \kerning1 \dbch \af2
\langfenp2052 \cf1 clasificate drept astmatiforme trebuie inclusi in protocol de
diagnostic alrefluxului gastroesofagian.}{\fs24 \kerning1 \dbch \af2 \hich \af0
420 \cufi0 \li420 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin420
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Semne clinice datorita
complicatiilor: anemie feripriva, HDS prin hematemeza sau}{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }
\langfenp2052 \cf1 melena, triada Saint (hernie hiatala calculi biliary
diverticuloza colonica) si}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 n}{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 drom}
\f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Roviralta (hernie hiatala,
stenoza hipertrofica de pilor la nounascut)}{\fs24 \kerning1 \dbch \af2 \hich
Imagistic - }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9
\langfenp2052 \cf17 T}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf17 ranzit baritat cu intoarcerea
pacientului in}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf17 }{\b1 \fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf17 Trendelemburg}{\fs26
\cf1 ,}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052
\langfenp2052 \cf1 \par }\pard \plain \fi-425 \cufi0 \li1265 \culi0 \ri0 \lisb0
\lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin1265 \rin0 \tql \tx425 \itap0 \ls10
\hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 1.\tab }
\langfenp2052 \cf1 Aparitia reflux gastroesofagian si a masivitatii sale}{\fs24
\langfenp2052 \par }\pard \plain \fi-425 \cufi0 \li1265 \culi0 \ri0 \lisb0
\lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin1265 \rin0 \tql \tx425 \itap0 \ls10
\langfenp2052 \cf1 pozitia jonctiunii esogastrice fata de hiatusuldiaphragmatic.}
\lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin1265 \rin0 \tql \tx425 \itap0
\hich \af0 \loch \af5 \lang1033 \langnp1033
\langfe2052 \langfenp2052 \f2 3.\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 pozitia stomacului care vor pune
diagnosticul de forma in cazul herniei hiatale.}{\fs24 \kerning1 \dbch \af2
\plain \li0 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin0
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf17 Endoscopia digestiva
superioara}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 permite evaluare gradului de esofagita de reflux.}
\langfe2052 \langfenp2052 \par }\pard \plain \li0 \culi0 \ri0 \lisb0 \lisa0
\langfenp2052 \cf17 Esomanometria si monitorizarea prin tubaj esogastric a
refluxului acid}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 sunt metode vechi dificil de organizat si condus in
populatia pediatrica}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
Persisten\uc1 \u539 ?a canalului peritoneovaginal}{\fs30 \kerning1 \dbch \af2 \hich
\langnp9 \langfe2052 \langfenp2052 \cf3 \par }\pard \plain \li0 \culi0 \ri0
{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052
\langfenp2052 \cf3 Hernie inghinal}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf3 \uc1 \u259 ?}{\b1 \fs26
\cf3 indirect}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf3 \uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf3 Hidrocel}{\fs24 \kerning1 \dbch \af2
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf3 Chist de cordon spermatic}{\fs24
\langfenp2052 \par }\pard \plain \li0 \culi0 \ri0 \lisb0 \lisa0 \nowidctlpar
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf3 Chist de
canal Nuck}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfenp2052 \cf3 HERNIA INGHINAL}{\b0 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf3 \uc1 \u258 ?}{\b0 \fs26
\cf3 INDIRECT}{\b0 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf3 \uc1 \u258 ?}{\b0 \fs24 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 20% dintre pacien\uc1 \u539 ?i sunt asimptomatici}
\cf1 Clinic-}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 Forma\uc1 \u539 ?iune pseudotumoral}{\fs26 \kerning1
\dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1
\cf1 Inghinal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9
\af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 /inghino-scrotal}
\langfenp2052 \cf1 \uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfe2052 \langfenp2052 \cf1 Consisten}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1 \u539 ?\uc1 \u259 ?}
\langfenp2052 \cf14 renitent-elastic}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf14 \uc1 \u259 ?}{\b1
\langfe2052 \langfenp2052 \cf14 \par }\pard \plain \fi-360 \cufi0 \li720 \culi0
\ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls11 \fs24
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 3.\tab }{\b1
\langfenp2052 \cf14 Reductibil}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf14 \uc1 \u259 ?}{\b1 \fs26
\cf14
}{\b0 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052
\langfenp2052 \cf14 prin manevre de taxis}{\b1 \fs24 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf14 \par }\pard
\langfe2052 \langfenp2052 \f2 4.\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf14 Expansiv}{\b1 \fs26
\cf14 \uc1 \u259 ?}{\b0 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9
\langnp9 \langfe2052 \langfenp2052 \cf14 la efort sau la cre\uc1 \u537 ?terea
presiunii}{\b0 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 }{\b0 \fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf14 intraabdominale}{\b1
\langfe2052 \langfenp2052 \cf14 \par }\pard \plain \fi-360 \cufi0 \li720 \culi0
\ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls11 \fs24
\langfenp2052 \cf14 Nedureroas}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls11 \fs24
\cf1 +/- }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf14 modific}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf14 \uc1 \u259 ?}{\fs26
\cf14 ri la nivelul tegumentelor supraiacente}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 .}{\fs26
\lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls11 \fs24
\langfe2052 \langfenp2052 \cf14 Permite palparea testiculului }{\b0 \fs26 \kerning1
\cf14 la polul inferior}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 }{\fs26 \kerning1 \dbch \af2
->Volum \uc1 \u537 ?i consisten\uc1 \u539 ?a normal\uc1 \u259 ?}{\fs26 \kerning1
\langfe2052 \langfenp2052 \cf1 Hernie strangulata->Forma\uc1 \u539 ?iunea de la
nivelul regiunii inghinale }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\culi200 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24
\langnp2057 \langfe2052 \langfenp2052 \cf1 -NU se poate reduce}{\fs26 \kerning1
\cf1 \par }\pard \plain \li0 \culi200 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Dureroas\uc1
\langfe2052 \langfenp2052 \cf1 \par }\pard \plain \li0 \culi200 \ri0 \lisb0
\langfenp2052 \cf1 -\uc1 \u206 ?n tensiune}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \par }\pard
\plain \li0 \culi200 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -NU se poate palpa marginea
superioar\uc1 \u259 ? }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 : }{\b1 \fs26 \kerning1
\cf17 Ecografia de canal inghinal}{\b1 \fs24 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Util}{\fs26
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 pentru diagnosticul
diferen\uc1 \u539 ?ial}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfe2052 \langfenp2052 \cf1 Explorare contralateral}{\fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 Canal peritoneovaginal persistent}{\b1 \fs24
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 4.\tab }{\b1 \fs26 \kerning1
\dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 \ul1 Orificiul inghinal intern > 4-5
mm}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 diametru}{\fs24 \kerning1 \dbch \af2 \hich \af0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf3 HIDROCELUL}{\fs28 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Clin }{\b1 \fs26 \kerning1
\cf1 Forma\uc1 \u539 ?iune pseudotumoral}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f8 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}
\itap0 \ls13 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033 \langnp1033
\langfe2052 \langfenp2052 \cf1 Consisten}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f8 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u539 ?\uc1
\langfe2052 \langfenp2052 \cf1 }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 lichidian}{\b1
\nowidctlpar \hyphpar0 \lin425 \rin0 \jclisttab \tx425 \itap0 \ls13 \fs24 \kerning1
\cf14 Transparent}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 \uc1 \u259 ?}{\b1 \fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf14 la manevra de }{\b0 \fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 \ul1
transiluminare}{\b1 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \cf14 \par }\pard \plain \fi-425 \cufi0
\li425 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin425 \rin0
\langfenp2052 \f2 3.\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 Nedureroas}{\b1 \fs26
\langfenp2052 \cf14 \uc1 \u259 ?}{\b1 \fs24 \kerning1 \dbch \af2 \hich \af0
\hyphpar0 \lin425 \rin0 \jclisttab \tx425 \itap0 \ls13 \fs24 \kerning1 \dbch
\cf14 Tegumente supraiacente indemne}{\fs24 \kerning1 \dbch \af2 \hich \af0
425 \cufi0 \li425 \culi0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin425 \rin0
\tql \tx425 \itap0 \ls13 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033
5.\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 Palpare }{\b1 \i1 \fs26 \kerning1 \dbch
\ul1 dificil}{\b1 \i1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 \ul1 \uc1 \u259 ?}{\b1 \i1 \fs26
\langfenp2052 \cf14 \ul1 }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 a testiculului}{\fs24
\cf1 Dimensiuni variabile Mai mare seara ,dup}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f8 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}
\langfe2052 \langfenp2052 \cf1 efort, dup}{\fs26 \kerning1 \dbch \af2 \hich
\langfe2052 \langfenp2052 \cf1 infec\uc1 \u539 ?ii}{\fs24 \kerning1 \dbch \af2
\plain \li0 \culi0 \ri0 \lisb0 \lisa0 \pnrnot0 \nowidctlpar \hyphpar0 \lin0
\langfenp2052 \cf1 Diagnostic imagistic }{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 - }{\b1 \fs26
\langfenp2052 \cf17 Ecografie canal inghinal \uc1 \u537 ?i testicular}{\b1 \fs26
\langfenp2052 \cf17 \uc1 \u259 ?}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 bilateral}{\b1
\cf1 - Cantitate normal}{\fs26 \kerning1 \dbch \af2 \hich
\langfe2052 \langfenp2052 \cf1 de lichid peritesticular 2-3 mm (}{\fs26
\kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \ul1 >2-3 mm}
\langfe2052 \langfenp2052 \cf1 )}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf3 CHISTUL DE CORDON SPERMATIC (DE CANAL NUCK - la
femei)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Forma\uc1 \u539 ?iune pseudotumoral}{\fs26 \kerning1 \dbch \af2 \hich \af0
\lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin845 \rin0 \tql \tx425 \itap0 \ls14
\langfe2052 \langfenp2052 \cf1 Localizat}{\fs26 \kerning1 \dbch \af2 \hich \af0
\langfe2052 \langfenp2052 \cf1 la nivelul regiunii inghinale}{\fs24 \kerning1
\cf1 Consisten}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u539 ?\uc1 \u259 ?}{\b1 \fs26
\langfenp2052 \cf14 lichidian}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\lisa0 \nowidctlpar \hyphpar0 \lin845 \rin0 \tql \tx425 \itap0 \ls14 \fs24
\langfe2052 \langfenp2052 \cf14 Ireductibil}{\b1 \fs26 \kerning1 \dbch \af2
\u259 ?}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 prin taxis}{\fs24 \kerning1 \dbch \af2
\hyphpar0 \lin845 \rin0 \tql \tx425 \itap0 \ls14 \fs24 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \f2 4.\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 Nedureroas}{\b1
\cf14 Testicul palpabil la nivelul hemiscrotului}{\b1 \fs24 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 Diagnostic imagistic }{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}{\b1
\langfe2052 \langfenp2052 \cf17 Ecografie canal inghinal bilateral}{\b1 \fs24
-Forma\uc1 \u539 ?iune }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \ul1 chistic}{\fs26
\langfenp2052 \cf1 \ul1 \uc1 \u259 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \ul1 }{\fs26
\langfenp2052 \cf1 bine delimitat}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f8 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}{\fs26
\langfenp2052 \cf1 la nivel inghinal .}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf3 Torsiunea de testicul(Sindrom
Scrotal)}{\b1 \fs32 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\langfe2052 \langfenp2052 {\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 2 peak-uri -Sub v\uc1
\u226 ?rsta de 3 ani}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi1300 \cufi500 \li0 \ri0
\langfe2052 \langfenp2052 \cf1 -Dup}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 pubertate}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Clinic}
\langfe2052 \langfenp2052 \cf1 Durere cu debut brusc, unilateral}{\fs26
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 , la nivelul scrotului}
\langfe2052 \langfenp2052 \cf1 Iradiere la nivelul abdomenului inferior \uc1
\u537 ?i coapsei}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfenp2052 \f2 3.\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Grea}{\fs26 \kerning1 \dbch
\u539 ?\uc1 \u259 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 , v}{\fs26 \kerning1 \dbch \af2 \hich
\langfe2052 \langfenp2052 \cf1 rs}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 turi}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Pot ap}{\fs26
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 rea episoade de torsiune
intermitent}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2
\langfenp2052 \cf1 Examen fizic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Testicul de dimensiuni m}{\fs26 \kerning1 \dbch \af2 \hich
\langfe2052 \langfenp2052 \cf1 rite}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 Pozi\uc1 \u539 ?ie \uc1 \u238 ?nalt}{\fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 scrotal}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Pozi\uc1 \u539 ?ie
transversal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 , cu
epididimul situat anterior}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Tegumente scrotale edema\uc1 \u539 ?iate, hiperemice}{\fs24
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Reflex cremasterian
absent}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 Examinare dificil}{\fs26 \kerning1
\cf1 \uc1 \u259 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 din cauza durerii}{\fs24 \kerning1
\langfenp2052 \cf1 Paraclinic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\cf1 Sumar de urin}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 Excluderea patologiei inflamatorii (orhiepididimit}
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 )}{\fs24 \kerning1 \dbch \af2
Imagistic}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9
\hich \af0 \loch \f8 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}
\langfenp2052 \cf17 Ecografie testicular}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf17 \uc1 \u259 ?}{\b1
\langfe2052 \langfenp2052 \cf17 \par }\pard \plain \fi-360 \li720 \ri0 \lisb0
\langfenp2052 \cf1 Absen\uc1 \u539 ?a fluxului vascular testicular}{\fs24 \kerning1
\langnp9 \langfe2052 \langfenp2052 \cf1 Torsiunea cordonului spermatic}{\fs24
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf3 \par }\pard \plain \li0
\langfe2052 \langfenp2052 \cf3 Invagina\uc1 \u539 ?ia}{\fs32 \kerning1 \dbch
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Simptomatologie}{\fs24 \kerning1
\langnp9 \langfe2052 \langfenp2052 \cf1 Dureri abdominale colicative, cu debut
brusc}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Perioade
de agita\uc1 \u539 ?ie altern\uc1 \u226 ?nd cu perioade de acalmie}{\fs24 \kerning1
\langnp9 \langfe2052 \langfenp2052 \cf1 Semne de ocluzie intestinal}{\fs26
\langnp9 \langfe2052 \langfenp2052 \cf1 (tardiv)}{\fs24 \kerning1 \dbch \af2 \hich
\plain \fi-360 \li720 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin720 \rin0
\langnp9 \langfe2052 \langfenp2052 \cf1 Distensie abdominal}{\fs26 \kerning1
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 V}
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 rs}{\fs26 \kerning1 \dbch \af2 \hich
\langfenp2052 \cf1 turi \uc1 \u8211 ? ini\uc1 \u539 ?ial alimentare, ulterior
bilioase \uc1 \u537 ?i fecaloide}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\li720 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin720
\langnp9 \langfe2052 \langfenp2052 \cf1 Prezen\uc1 \u539 ?a scaunelor cu s\uc1
\u226 ?nge proasp}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 t sau digerat}
\langfe2052 \langfenp2052 \cf1 (a}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 spect caracteristic de \uc1
\u8221 ?jeleu de coac}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 ze\uc1
\langfe2052 \langfenp2052 \cf1 ).}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Examen fizic}
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Ini\uc1
\u539 ?ial abdomen de aspect normal, ulterior apare distensia progresiv}{\fs26
\langfenp2052 \cf1 Palparea tumorii de invagina\uc1 \u539 ?ie}{\fs26 \kerning1
\cf1 - c}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 el mai frecvent subhepatic}{\fs24 \kerning1 \dbch
\langnp9 \langfe2052 \langfenp2052 \cf1 Fosa iliac}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}
\langfenp2052 \cf1 dreapt}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}{\fs26 \kerning1
poate fi \uc1 \u8221 ?goal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?\uc1 \u8221 ?}{\fs26
\cf1 (semnul Dance)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfenp2052 \cf1 Tu\uc1 \u537 ?eu rectal}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}{\fs26
\cf1 S\uc1 \u226 ?nge proasp}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 t
sau digerat, mucus}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 -}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Prolaps al segmentului invaginat
prin anus}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Imagistic}{\b1 \fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1 \u259
?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
Ecografia abdominal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs24
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}
\langfenp2052 \cf1 Imagine \uc1 \u238 ?n \uc1 \u8221 ?cocard}{\fs26 \kerning1 \dbch
?\uc1 \u8221 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? sec\uc1 \u539 ?iune transversal}
\langfenp2052 \cf1 \uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf1 -}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Imagine de \uc1
\u8221 ?pseudorinichi\uc1 \u8221 ? \uc1 \u8211 ? sec\uc1 \u539 ?iune longitudinal}
\langfenp2052 \cf1 -}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Poate identifica puncte de
plecare patologice}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Radiografia abdominal}{\fs26
\langnp9 \langfe2052 \langfenp2052 \cf1 simpl}{\fs26 \kerning1 \dbch \af2 \hich
\f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Nivele hidroaerice}{\fs24
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1
\langfenp2052 \cf1 Valoare limitat}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\uc1 \u238 ?n diagnostic.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\cf1 CT, IRM.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfe2052 \langfenp2052 \cf3 Diverticul Meckel - complicatii}{\fs32 \kerning1
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Hemoragie \uc1 \u8211 ? 30-50% din
cazuri}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9
\langnp9 \langfe2052 \langfenp2052 \cf1 Episoade de hemoragie digestiv}{\fs26
\langnp9 \langfe2052 \langfenp2052 \cf1 inferioar}{\fs26 \kerning1 \dbch \af2
\langfenp2052 \cf1 nedureroas}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs26
\cf1 Asociaz}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9
\af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 frecvent anemie}
\langfe2052 \langfenp2052 \cf1 }{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Cauzat de
prezen\uc1 \u539 ?a mucoasei gastrice heterotopice (ulcer peptic)}{\fs24
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Ocluzia intestinal}
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 15-40%}{\fs26 \kerning1 \dbch
\langfenp2052 \cf1 Invagina\uc1 \u539 ?ie ileoileal}{\fs26 \kerning1 \dbch \af2
\langfenp2052 \cf1 sau ileocolic}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1
\langfenp2052 \cf1 Volvulus \uc1 \u8211 ? diverticular sau enterodiverticular}
\langfe2052 \langfenp2052 \par }\pard
Diverticulit}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9
\af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? 5-15%}
\cf1 -}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 Prezen\uc1 \u539 ?a mucoasei gastrice sau
pancreatice}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 heterotopice}{\fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 }{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -S}{\fs26
\cf1 imptomatologie asem}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 n}{\fs26
\langnp9 \langfe2052 \langfenp2052 \cf1 toare apendicitei}{\fs24 \kerning1 \dbch
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Herniile Meckeliene (Littre)}
\langfe2052 \langfenp2052 \cf1 - }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Diverticul Meckel \uc1 \u238 ?n
sacul unei hernii inghinale, femurale, ombilicale, Spigel}{\fs24 \kerning1
\langfenp2052 \cf1 Tumori Benigne \uc1 \u8211 ? lipoame, fibroame, angioame,
neurofibroame}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 Maligne \uc1 \u8211 ? adenocarcinom, sarcom, tumor}
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 carcinoid}{\fs26 \kerning1 \dbch
?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057 \langnp2057
\cf3 Boala Hirschsprung }{\fs40 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs32 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Diagnostic clinic}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 La sugar}{\fs24 \kerning1
{\uc1 \u65399 ?}30\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Constipa\uc1 \u539 ?ia
-Apare la c\uc1 \u226 ?teva luni, o dat}{\fs26 \kerning1 \dbch \af2 \hich \af0
\langfe2052 \langfenp2052 \cf1 cu diversificarea}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 -Scaun la 3-
4 zile}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\pard \plain \fs24
\langfenp2052 \f2 {\uc1 \u65399 ?}31\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Abdomen destins}
Hipotrofie staturoponderal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}{\fs24
Poate s}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057 \langnp2057
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 apar}{\fs26
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 tablou clinic: ocluzie
intestinal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1
Enterocolit}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 .}
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 La copilul mare}{\fs24 \kerning1
\langnp9 \langfe2052 \langfenp2052 \cf1 Constipa\uc1 \u539 ?ia cronic}{\fs26
\langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Episoade de
constipa\uc1 \u539 ?ie ce alterneaz}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f8 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?}{\fs26 \kerning1
\dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 cu
episoade de diaree.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfenp2052 \cf1 Abdomen destins}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langnp9 \langfe2052 \langfenp2052 \cf1 Meteorism generalizat}{\fs24 \kerning1
\langnp9 \langfe2052 \langfenp2052 \cf1 Circula\uc1 \u539 ?ie venoas}{\fs26
\langnp9 \langfe2052 \langfenp2052 \cf1 colateral}{\fs26 \kerning1 \dbch \af2
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Retard
staturoponderal}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfenp2052 \cf1 Tu\uc1 \u537 ?eul rectal}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}
\langfenp2052 \cf1 Canal anal \uc1 \u238 ?ngustat}{\fs24 \kerning1 \dbch \af2 \hich
\langfe2052 \langfenp2052 \cf1 -Spastic}{\fs24
-Ampul}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9 \langnp9 \langfe2052
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 rectal}{\fs26 \kerning1 \dbch
?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052
\langfenp2052 \cf1 goal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 .}{\fs24
\loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 \par }\pard \plain \li0
\dbch \af2 \hich
\cf1 Diagnostic paraclinic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\cf1 1.Investiga\uc1 \u539 ?iile radiologice cu substan}{\fs26 \kerning1 \dbch \af2
\langnp9 \langfe2052 \langfenp2052 \cf1 de contrast}{\fs24 \kerning1 \dbch \af2
\langnp9 \langfe2052 \langfenp2052 \cf1 Zona de tranzi\uc1 \u539 ?ie}{\fs24
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }
\langfenp2052 \cf1 Segmentul colonic distal nedilatat}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs26
\cf1 Segmentul proximal mult dilatat}{\fs24 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li720
Caracteristic pentru boala Hirschsprung}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 -}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 raportul diametrul
rectului/diametrul sigmoidului < 1}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 -}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 zon}{\fs26 \kerning1 \dbch \af2
\langfenp2052 \cf1 de tranzi\uc1 \u539 ?ie \uc1 \u238 ?ngust}{\fs26 \kerning1
\langfe2052 \langfenp2052 \cf1 absen\uc1 \u539 ?a haustra\uc1 \u539 ?iilor}
\langfe2052 \langfenp2052 \cf1 persisten\uc1 \u539 ?a unei mici cantit}{\fs26
\cf1 \uc1 \u259 ?\uc1 \u539 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 i de bariu la nivel colonului -> pe
radiografie ulterioar}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 2.Manometrie anorectal}{\fs26
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 13.\tab }{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 presiunea
de la nivelul rectului \uc1 \u537 ?i canalului anal}{\fs24 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 reflexul inhibitor anorectal absent}{\fs26 \kerning1
\cf1 - }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang9 \langnp9
\langfe2052 \langfenp2052 \cf1 sfincterul intern nu se relaxeaz}{\fs26 \kerning1
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 3.Biopsia rectal}{\fs26 \kerning1
\f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Diagnostic de certitudine}{\fs24
\kerning1 \dbch \af2 \hich \af0
360 \li720 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin720 \rin0 \itap0 \ls5
\langfenp2052 \cf1 Absen}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang9
\hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 a celulelor
ganglionare}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\af2 \hich \af0 \loch \f7 \lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 Prezen}
\lang9 \langnp9 \langfe2052 \langfenp2052 \cf1 a fibrelor nervoase amielinice
hipertrofiate}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 .}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf3 Stenoza hipertrofic}{\fs40 \kerning1
\langnp2057 \langfe2052 \langfenp2052 \cf3 de pilor}{\fs32 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Simptomatologie}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf1 V}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 rs}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 turi
alimentare, nebilioase, \uc1 \u238 ?n jet,postprandiale}{\fs24 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 Apar la 14-21 zile de la na\uc1 \u537 ?tere}
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Agita\uc1 \u539 ?ie
\uc1 \u238 ?ntre mese}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\af2 \hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Pot
ap}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057 \langnp2057
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 rea v}{\fs26
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 rs}{\fs26 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 turi \uc1 \u238 ?n \uc1 \u8221 ?za\uc1 \u539 ? de
cafea\uc1 \u8221 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
Stagnare \uc1 \u238 ?n greutate, apoi sc}{\fs26 \kerning1 \dbch \af2 \hich \af0
\langfe2052 \langfenp2052 \cf1 dere}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 Constipa\uc1 \u539 ?ie \uc1 \u8211 ? scaune rare, sub form}
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 de scibale}
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Urini hipercrome,
concentrate}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Examen fizic}{\fs24
Semne de deshidratare}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1
-pliu cutanat lene\uc1 \u537 ?, deprimarea fontanelei, mucoase uscate}
\cf1 -dispari\uc1 \u539 ?ia bulei lui Bichat}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -fa}{\fs26
\langfenp2052 \cf1 \uc1 \u539 ?\uc1 \u259 ?}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8221 ?
de b}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057 \langnp2057
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 tr\uc1 \u226 ?
n\uc1 \u8221 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfe2052 \langfenp2052 \cf1 Abdomen suplu, nedureros}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 -unde peristaltice
gastrice vizibile}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 -perioade de acalmie \uc1 \u8211 ? se poate palpa \uc1 \u8221
?oliva piloric}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u259 ?\uc1 \u8221 ?}{\fs26
\langfenp2052 \cf1 (forma\uc1 \u539 ?iune ferm}{\fs26 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 , dur}{\fs26 \kerning1 \dbch \af2 \hich \af0
\langfe2052 \langfenp2052 \cf1 , mobil}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 , de aprox. 2 cm, \uc1 \u238 ?n epigastru)}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf1 Analize de laborator}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Alcaloz}{\fs26 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 metabolic}{\fs26 \kerning1 \dbch \af2 \hich \af0
\cf1 Hipocloremie, hiponatremie, hipopotasemie}{\fs24 \kerning1 \dbch \af2 \hich
\langfenp2052 \cf1 Imagistic}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Ecografie abdominal}
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ?
hipertrofia pilorului}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Grosimea muscularei - > 4 mm}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Lungimea canalului
piloric - > 16 mm}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Diametrul pilorului - > 14 mm}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Tranzit esogastric Canal
piloric \uc1 \u238 ?ngustat, filiform, alungit, situat central}{\fs24 \kerning1
Dilata\uc1 \u539 ?ie gastric}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\langfenp2052 \cf1 , lichid de staz}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 , evacuare \uc1 \u238 ?nt\uc1 \u226 ?rziat}{\fs26 \kerning1
\dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 .}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf3 Stenoza \uc1 \u537 ?i atrezia de duoden}{\fs30 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Prenatal}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Ecografie fetal}{\fs26 \kerning1
\langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? L7 de gesta\uc1 \u539 ?
ie}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 2 structuri cu con\uc1 \u539 ?inut lichidian (aspect de \uc1 \u8221 ?double-
bubble\uc1 \u8221 ?)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Simptomatologie}{\fs24
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Obstacol
supraampular \uc1 \u8211 ? v}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\langfenp2052 \cf1 rs}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 turi
alimentare, nonbilioase}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Obstacol subampular \uc1 \u8211 ? v}{\fs26 \kerning1 \dbch
\langfenp2052 \cf1 turi bilioase}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf1 Obstacol complet \uc1 \u8211 ? v}{\fs26 \kerning1
\langnp2057 \langfe2052 \langfenp2052 \cf1 rs}{\fs26 \kerning1 \dbch \af2 \hich
\langfe2052 \langfenp2052 \cf1 turi din prima zi de via}{\fs26 \kerning1 \dbch \af2
\cf1 Obstacol incomplet \uc1 \u8211 ? v}{\fs26 \kerning1 \dbch \af2 \hich \af0
\langfenp2052 \cf1 turi tardive}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Examen
fizic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
Semne de deshidratare - pliu cutanat lene\uc1 \u537 ?, fontanel}{\fs26 \kerning1
\langnp2057 \langfe2052 \langfenp2052 \cf1 deprimat}{\fs26 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Abdomen excavat (lipsa aer}{\fs26
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 rii distale \uc1 \u238 ?n
cazul obstruc\uc1 \u539 ?iilor complete).}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Nu elimin}{\fs26 \kerning1
\langnp2057 \langfe2052 \langfenp2052 \cf1 meconiu , elimin}{\fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 glere..}{\fs24 \kerning1 \dbch \af2 \hich \af0
\hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 {\uc1
\langnp2057 \langfe2052 \langfenp2052 \cf1 Sc}{\fs26 \kerning1 \dbch \af2 \hich
\langfe2052 \langfenp2052 \cf1 dere \uc1 \u238 ?n greutate}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf1 Imagistic}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\langfenp2052 \f2 {\uc1 \u65399 ?}48\tab }{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Radiografia
abdominal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057 \langnp2057
\af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 simpl}
\af0 \loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \line }{\fs26
\langfenp2052 \cf1 Semn patognomonic \uc1 \u8211 ? \uc1 \u8221 ?double
bubble\uc1 \u8221 ?, \uc1 \u8221 ?taler de balan}{\fs26 \kerning1 \dbch \af2
\u539 ?\uc1 \u259 ?\uc1 \u8221 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \line }{\fs26 \kerning1
\cf1 Absen\uc1 \u539 ?a pneumatiz}{\fs26 \kerning1 \dbch \af2 \hich \af0
\langfe2052 \langfenp2052 \cf1 rii intestinale distale (obstacol complet)}{\fs24
Tranzit esogastroduodenal - diagnosticul formelor incomplete}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Ecografia abdominal}{\fs26
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 - util}{\fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 \uc1 \u238 ?n diagnosticul diferen\uc1 \u539 ?ial}
\cf3 Malformatii bronhopulmonare \uc1 \u8211 ? Diagnostic diferen\uc1 \u539 ?ial}
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Sechestra\uc1 \u539 ?ia
bronhopulmonar}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\langfe2052 \langfenp2052 \cf1 Hernia diafragmatic}{\fs26 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 congenital}{\fs26 \kerning1 \dbch \af2 \hich
\pard \plain \fs24
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Chistul bronhogenic}{\fs24
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Emfizemul congenital
lobar}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Emfizem pulmonar
intersti\uc1 \u539 ?ial localizat - pacien\uc1 \u539 ?i ventila\uc1 \u539 ?i
mecanic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Pneumatocel - sechele
post-pneumonie bacterian}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang2057
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf3 Gastroschizis (laparoschizis)}
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 Modific}{\fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 ri macroscopice la nivelul anselor intestinale}
Ansele edema\uc1 \u539 ?iate, cartonate, de culoare violacee, aperistaltice}
\af2 \hich \af0 \loch \f7 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 D}
\langfe2052 \langfenp2052 \cf1 epozite de fibirin}{\fs26 \kerning1 \dbch \af2 \hich
\li1170 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin1170 \rin0 \itap0 \ls8
\langnp1033 \langfe2052 \langfenp2052 \cf1 M}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 ultiple
aderen\uc1 \u539 ?e \uc1 \u537 ?i false membrane}{\fs24 \kerning1 \dbch \af2
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 A}{\fs26 \kerning1 \dbch
spect caracteristic de peritonit}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\langfenp2052 \cf1 plastic}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\langfenp2052 \cf1 .}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Diagnostic prenatal}{\fs24
\loch \f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Ecografie
morfofetal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang1048
\hich \af0 \loch \f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 -
Trimtestrul I de sarcin}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\loch \f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Eviden\uc1
\u539 ?iaz}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang1048
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 Defect abdominal}{\fs24
\af2 \hich \af0 \loch \f7 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 Anse
intestinale herniate}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi-450 \li1170 \ri0
\langfe2052 \langfenp2052 \cf1 Inser\uc1 \u539 ?ia anormal}{\fs26 \kerning1
\langnp1033 \langfe2052 \langfenp2052 \cf1 a cordonului ombilical }{\fs24
\loch \f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 IRM fetal.}{\fs24
\langnp1048 \langfe2052 \langfenp2052 \cf1 Diagnostic pozitiv}{\fs24 \kerning1
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Aspectul clinic caracteristic:
\langfenp2052 \cf1 defect }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 la nivelul}{\fs26 \kerning1
\cf1 perete}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang1048 \langnp1048
\langfe2052 \langfenp2052 \cf1 lui}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 abdominal}{\fs24 \kerning1
e}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang1033 \langnp1033
\langfe2052 \langfenp2052 \cf1 xteriorizarea organelor abdominale.}{\fs24 \kerning1
\cf3 Omfalocel}{\fs40 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang1048
Cordonul ombilical inserat inferior}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf1 Sacul con\uc1 \u539 ?ine anse intestinale,
dar }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang1033 \langnp1033
\af0 \loch \f7 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 i ficat.}{\fs24
Cavitatea abdominal}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang1033
hipoplazic}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang1033
\hich \af0 \loch \f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 - i}
\langfe2052 \langfenp2052 \cf1 nvers propor\uc1 \u539 ?ional}{\fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 cu con\uc1 \u539 ?inutul omfalocelului.}{\fs24
\langnp1046 \langfe2052 \langfenp2052 \cf1 Diagnostic prenatal}{\fs24 \kerning1
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 Ecografie morfofetal}{\fs26
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? trimestrul I de
sarcin}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang1033 \langnp1033
\langnp1048 \langfe2052 \langfenp2052 \cf1 }{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f7 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \cf1 Se
eviden\uc1 \u539 ?iaz}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang1033
\hich \af0 \loch \f7 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 }{\fs26
\langfenp2052 \cf1 Defect abdominal central}{\fs24 \kerning1 \dbch \af2 \hich
\langnp1033 \langfe2052 \langfenp2052 \cf1 Sac
herniar con\uc1 \u539 ?in}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\langfenp2052 \cf1 nd viscere abdominale}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp1033 \langfe2052 \langfenp2052 \cf1 Ecografia prin abord transvaginal}{\fs24
Na\uc1 \u537 ?terea se poate face pe cale vaginal}{\fs26 \kerning1 \dbch \af2 \hich
\lang1046 \langnp1046 \langfe2052 \langfenp2052 \cf1 Diagnostic }{\b1 \fs26
\langfenp2052 \cf1 pozitiv}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Aspectul clinic caracteristic}{\fs24 \kerning1 \dbch \af2
\langfe2052 \langfenp2052 \cf1 Defect abdominal larg (> 4 cm)}{\fs24 \kerning1
\par }\pard \plain \fi-450 \li1170 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Eventratie }{\fs26
\langfenp2052 \cf1 situat}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8
\langfenp2052 \cf1 centra}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 l, la nivelul ombilicului.}
\langfe2052 \langfenp2052 \cf3 Persisten\uc1 \u539 ?a ductului omfaloenteric}{\fs30
\loch \f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Fistul}{\fs26
\kerning1 \dbch \af2 \hich
\langfe2052 \langfenp2052 \cf1 , sinus sau chist}{\fs24 \kerning1 \dbch \af2
{\uc1 \u65399 ?}63\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Clinic}{\fs24 \kerning1
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Lipsa cicatriz}{\fs26
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 rii pl}{\fs26 \kerning1
\langnp1048 \langfe2052 \langfenp2052 \cf1 gii ombilicale}{\fs24 \kerning1 \dbch
\lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Fistul}{\fs26 \kerning1
\langnp1048 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? exteriorizarea de lichid
fecaloid}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 Sinus \uc1 \u8211 ?
secre\uc1 \u539 ?ie mucopurulent}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \f2 {\uc1 \u65399 ?}64\tab }{\b1 \fs26 \kerning1 \dbch
Imagistic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\nowidctlpar \hyphpar0 \lin1440 \rin0 \itap0 \fs24 \kerning1 \dbch \af2 \hich
\af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\fs26 \kerning1
\cf1 Ecografie p}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f8 \lang1048
\hich \af0 \loch \f7 \lang1048 \langnp1048 \langfe2052 \langfenp2052 \cf1 r\uc1
\u539 ?i moi}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Fistulografie.}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f7 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1
\langfenp2052 \par }\pard \plain \li0 \ri0 \lisb0 \sa200 \lisa0 \nowidctlpar
\langfenp2052 \cf1 \par }\pard \plain \li0 \ri0 \lisb0 \sa200 \lisa0
\langfe2052 \langfenp2052 \cf3 Malformatii renale }{\fs30 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Anomalii de dezvoltare -}{\fs26
\langfenp2052 \cf1 Displazia renal\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich
\langnp1033 \langfe2052 \langfenp2052 }{\fs26 \kerning1
\cf1 -Hipoplazia renal\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Anomalii de num\uc1 \u259 ?r -}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Agenezia
renala}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 -Rinichi supranumerar}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Anomalii de migrare -}{\fs26
\langfenp2052 \cf1 Ectopia renal\uc1 \u259 ? simpl\uc1 \u259 ?}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Anomalii de fuziune -}
\langfe2052 \langfenp2052 \cf1 Rinichiul in potcoava}{\fs24 \kerning1 \dbch \af2
\plain \fi2380 \li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Ectopia renala incrucisata}
{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li0
\cf9 Rinichiul displazic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi720 \li0 \ri0 \lisb0
\langfenp2052 \cf1 Tubuli renali primitivi}{\fs24 \kerning1 \dbch \af2 \hich
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Nu necesit\uc1 \u259 ?
conduit\uc1 \u259 ? terapeutic\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 14% din cazuri \uc1 \u8211 ?
reflux vezico-ureteral contralateral}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langfenp2052 \cf9 Hipoplazia renal\uc1 \u259 ? }{\fs24 \kerning1 \dbch \af2
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Rinichi normal conformat}
\langfe2052 \langfenp2052 \par }\pard \plain \fi720 \li0 \ri0 \lisb0 \lisa0
\cf1 Dimensiuni sc\uc1 \u259 ?zute}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi720 \li0 \ri0
\langfe2052 \langfenp2052 \cf1 Num\uc1 \u259 ?r redus de nefroni}{\fs24
\langfenp2052 \par }\pard \plain \fi720 \li0 \ri0 \lisb0 \lisa0 \nowidctlpar
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf9 Agenezia renal\uc1 \u259 ? }
\cf16 A)unilateral\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Inciden\uc1 \u539 ?a \uc1 \u8211 ? 1/1.000 nou-n\uc1 \u259 ?
scu\uc1 \u539 ?i}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 M/F \uc1 \u8211 ? 2/1}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Asociat\uc1 \u259 ? frecvent cu alte malforma\uc1 \u539 ?ii
congenitale \uc1 \u8211 ? necesit\uc1 \u259 ? screening}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Cardiovasculare, gastrointestinale,
genitale, musculoscheletale}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Hipertrofia compensatorie a rinichiului contralateral}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 50% din cazuri
\uc1 \u8211 ? afectarea rinichiului contralateral}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Reflux vezicoureteral}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Sindrom de
jonc\uc1 \u539 ?iune pieloureteral\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Sindrom de jonc\uc1 \u539 ?iune
ureterovezical\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Necesit\uc1 \u259 ? investiga\uc1 \u539 ?ii func\uc1 \u539 ?
ionale ale rinichiului contralateral}{\fs24 \kerning1 \dbch \af2 \hich \af0
\lisa0
\cf16 B)bilateral\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Inciden\uc1 \u539 ?\uc1 \u259 ? \uc1 \u8211 ? 1/4.800 nou-
n\uc1 \u259 ?scu\uc1 \u539 ?i}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 M/F \uc1 \u8211 ? 3/1}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Arterele renale \uc1 \u351 ?i ureterele
sunt absente}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Vezica urinar\uc1 \u259 ? nu este dezvoltat\uc1 \u259 ? corespunz\uc1 \u259 ?
tor}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Malforma\uc1 \u539 ?ie incompatibil\uc1 \u259 ? cu via\uc1 \u539 ?a}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 40% dintre copiii se
nasc mor\uc1 \u355 ?i}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf9 Rinichi supranumerar}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Anomalie rar\uc1
\u259 ? (100 de cazuri)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 De mici dimensiuni}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Func\uc1 \u539 ?ia renal\uc1 \u259 ?
redus\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Frecvent asimptomatici}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Clinic -Infec\uc1 \u355 ?ii de tract urinar}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Dureri abdominale
cronice}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 -Palparea unei mase pseudotumorale abdominale}{\fs24 \kerning1 \dbch \af2
\langfenp2052 \cf9 Ectopia renal\uc1 \u259 ? simpl\uc1 \u259 ?}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Rinichi care nu este situat
\uc1 \u238 ?n loja renal\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Inciden\uc1 \u539 ?\uc1 \u259 ? \uc1
\u8211 ? 1/1.000 nou-n\uc1 \u259 ?scu\uc1 \u539 ?i}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Forme-Rinichi \uc1 \u8220 ?iliac\uc1
\u8221 ? \uc1 \u8211 ? deasupra crestei iliace}{\fs24 \kerning1 \dbch \af2 \hich
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Rinichi \uc1 \u8220 ?
pelvin\uc1 \u8221 ? \uc1 \u8211 ? sub bifurcatia aortei}{\fs24 \kerning1 \dbch \af2
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Rinichi subdiafragmatic
\uc1 \u8211 ? superior de loja renal\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2
\lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 -Rinichi toracic}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Diagnostic diferen\uc1 \u539 ?
ial ->Ptoza renal\uc1 \u259 ? \uc1 \u8211 ? ureter de lungime normal\uc1 \u259 ?,
cudat}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 De obicei asimptomatica}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Diagnostic \uc1 \u8211 ? imagistic ->Ecografie}{\fs24 \kerning1
\par }\pard \plain \fi720 \li2880 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 ->Scintigrafie}
\cf1 ->IRM, CT}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 40% din cazuri \uc1 \u8211 ? sindrom de jonctiune pieloureterala}{\fs24
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Necesita
management chirurgical}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
Rinichi \uc1 \u8220 ?\uc1 \u238 ?n potcoav\uc1 \u259 ?\uc1 \u8221 ?!!!!!!}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 2 versan\uc1 \u539 ?
i uni\uc1 \u539 ?i printr-un istm (90% din cazuri la polul inferior)}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 2/3 din cazuri -}
\langfe2052 \langfenp2052 \cf1 Reflux }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 vezicoureteral}{\fs24
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}{\b1
\langfe2052 \langfenp2052 \cf1 Duplica\uc1 \u539 ?ie}{\fs26 \kerning1 \dbch \af2
ureteral\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi2148 \li0 \ri0
\langfe2052 \langfenp2052 \cf1 -}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Sindrom de
jonc\uc1 \u539 ?iune pieloureteral\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}{\b1 \fs26 \kerning1
\cf1 Rinichi displazic multichistic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf1 Risc crescut de tumori maligne -}{\b1 \fs26
\langfenp2052 \cf8 Nefroblastom}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 -}{\b1 \fs26 \kerning1 \dbch
Carcinom renal}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf9 Ectopia renal\uc1 \u259 ? \uc1
\u238 ?ncruci\uc1 \u537 ?at\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Rinichi situat de partea cealalt\uc1
\u259 ? fa\uc1 \u539 ?\uc1 \u259 ? de implantarea ureterului \uc1 \u238 ?n vezica}
\cf1 Forme}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 -Cu fuziune \uc1 \u8211 ? rinichi
\uc1 \u238 ?n \uc1 \u8221 ?S\uc1 \u8221 ? sau \uc1 \u8221 ?L\uc1 \u8221 ?}{\fs24
\hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 -F\uc1 \u259 ?r\uc1 \u259 ? fuziune}
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Frecvent }{\b1 \fs26 \kerning1
\cf1 asociaz\uc1 \u259 ? }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u537 ?i alte
malforma\uc1 \u539 ?ii congenitale}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi640 \li0 \ri0
\langfe2052 \langfenp2052 \cf1 ->Cardiace, musculoscheletale, genitale,
gastrointestinale, anorectale, etc.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
2)\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf3 Displazia renal\uc1 \u259 ?
multichistic\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Cea mai frecvent\uc1 \u259 ? cauz\uc1 \u259 ? de mas\uc1 \u259 ? renal\uc1
\u259 ? chistic\uc1 \u259 ? la nou-n\uc1 \u259 ?scu\uc1 \u539 ?i}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Afectarea
bilateral\uc1 \u259 ? \uc1 \u8211 ? incompatibil\uc1 \u259 ? cu via\uc1 \u539 ?a
extrauterin\uc1 \u259 ?.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Parenchim renal \uc1 \u238 ?
nlocuit de multiple chiste-M\uc1 \u259 ?rime variabil\uc1 \u259 ?}{\fs24
\langfenp2052 \par }\pard \plain \li3600 \ri0 \lisb0 \lisa0 \nowidctlpar
-Grupate ca un}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 \uc1 \u8220 ?ciorchine de struguri\uc1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Diagnostic }{\fs26
\langfenp2052 \cf1 stabilit }{\i1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 antenatal }{\fs26
\langfenp2052 \cf1 \uc1 \u8211 ? }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 ecografie fetal\uc1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Diagnostic diferen\uc1 \u539 ?
ial}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Sindromul de jonc\uc1 \u539 ?iune pieloureteral\uc1 \u259 ?}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Chist central}
\cf1 -Conservarea formei renale}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 -Parenchim vizibil}{\fs24 \kerning1 \dbch \af2 \hich \af0
3)Sindromul de jonc\uc1 \u539 ?iune pieloureteral\uc1
\u259 ?(Hidronefroza congenitala)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Evacuarea urinii}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 din bazinet \uc1 \u238 ?n
ureter}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\langfe2052 \langfenp2052 \cf14 Inadecvat\uc1 \u259 ?, \uc1 \u238 ?ngreunat\uc1
\langfe2052 \langfenp2052 \cf14 Distensie hidrostatic\uc1 \u259 ?}{\fs26
\langfenp2052 \cf1 a bazinetului \uc1 \u537 ?i a calicelor}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Afectarea progresiv\uc1 \u259
? a func\uc1 \u539 ?iei renale}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Cea mai
frecvent\uc1 \u259 ? malforma\uc1 \u539 ?ie obstructiv\uc1 \u259 ? renal\uc1
\cf1 Inciden\uc1 \u539 ?\uc1 \u259 ? \uc1 \u8211 ? 1/1.250 nou-n\uc1 \u259 ?scu\uc1
\u539 ?i}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 M/F \uc1 \u8211 ? 2/1}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Diagnostic}{\fs24 \kerning1
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}{\b1 \fs26
\langfenp2052 \cf14 Infec\uc1 \u539 ?ii}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 de tract urinar}
\cf1 -}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 Dureri }{\fs26 \kerning1 \dbch \af2
abdominale, }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 grea\uc1 \u539 ?\uc1 \u259 ?, v\uc1
\u259 ?rs\uc1 \u259 ?turi, hematurie}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 (copiii mai mari)}
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Imagistic\uc1 \u259 ?}
\cf1 Diagnostic antenatal \uc1 \u8211 ?}{\b1 \fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 ecografie
fetal\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Ecografie renovezical\uc1
\cf17 Scintigrafia renal\uc1 \u259 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ?
func\uc1 \u539 ?ia renal\uc1 \u259 ? (poate stabili indica\uc1 \u539 ?ia
chirurgical\uc1 \u259 ?)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf17 Cistografia renal\uc1 \u259 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? excluderea
refluxului vezicoureteral}{\fs24
\langnp2057 \langfe2052 \langfenp2052 \cf1 Clasificare (aspect ecografic)}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf9 Grad 0}{\b1 \fs26
\langfenp2052 \cf1 \uc1 \u8211 ? }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 f\uc1 \u259 ?r\uc1 \u259 ?
dilata\uc1 \u539 ?ie bazinetal\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich
\langfenp2052 \cf9 Grad 1 }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\cf1 dilatarea }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 \ul1 bazinetului}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf9 Grad 2}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? }
\langfe2052 \langfenp2052 \cf1 dilatarea }{\b1 \fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1
accentuat\uc1 \u259 ? a bazinetului}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 , f\uc1 \u259 ?r\uc1 \u259
? dilatarea calicelor}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf9 Grad 3}{\b1 \fs26 \kerning1
\cf1 \uc1 \u8211 ? }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 dilatarea bazinetului \uc1 \u537 ?i a }
\langfe2052 \langfenp2052 \cf1 calicelor}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 ; parenchim renal
normal}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf9 Grad 4}{\b1 \fs26 \kerning1
\cf1 \uc1 \u8211 ? }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 dilatarea bazinetului \uc1 \u537 ?i a
calicelor; afectarea}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 parenchimului}{\fs24 \kerning1 \dbch
\cf3 4)Megaureterul (ureterohidronefroza)}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 =dilatatia }{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 si }
\langfe2052 \langfenp2052 \cf1 alungirea }{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 ureterului(apare si
printr-un obstacol sau reflux vezico-ureteral)}{\fs24 \kerning1 \dbch \af2 \hich
\langfenp2052 \cf1 Afectare intrinseca structurala a ureterului cu pierderea
peristalticii**}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 si a capacitatii de a transporta urina de la bazinet la vezica urinara.}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 La un adolescent : }
\langfe2052 \langfenp2052 \cf14 polakiurie, disurie, jena mictionala}{\fs26
\langfenp2052 \cf1 . }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1
La un copil mic nu apar niciunul din aceste simptome. Primul semn \uc1 \u8594 ?}
\langfe2052 \langfenp2052 \cf14 refuzul alimentatiei}{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 .
Alt semn \uc1 \u8594 ? }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 febra}{\fs26 \kerning1
\cf1 .}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf14 Faringele apare rosu si hiperemic}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 intr-un episod
febril, chiar daca copilul nu are faringita.}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Nu are catar nazal, nu are tuse, nu are
secretii nazale \uc1 \u8594 ? nu este faringita. !!! Nu uitam ca poate fi vorba de
o infectie urinara \uc1 \u8594 ? }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 sumar de urina si
urocultura }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 inainte de inceperea tratamentului
antibiotic.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 La megaureter: urina stagneaza in el \uc1 \u8594 ? urina tulbure, dar nu se
evacueaza tot timpul in VU, deoarece majoritatea megaureterelor sunt obstructive
\uc1 \u8594 ? mictiuni normale ce alterneaza cu urini tulburi.}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Urina tulbure nu apare doar in
infectii. De exemplu, poate aparea si in crioprecipitare.}{\fs24 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 Semnele clinice sunt necaracteristice datorate
infectiei urinare asociate }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Specific megaureterului sunt }
\langfe2052 \langfenp2052 \cf14 emisiile de urina purulenta, tulbure}{\fs26
\langfenp2052 \cf1 (aspect ce poate fi dat de sarurile existente in urina, nu
neaparat de germeni) ce pot alterna cu emisii de urina normala}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf1 Imagistic}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 : }{\fs24
\hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f4 u\'00\tab
\langfe2052 \langfenp2052 \cf17 Ecografie*}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 *Larg disponibila, repetitiva,
dependenta de operator. Variatiile de dimensiuni \uc1 \u8594 ? explicabile prin
faptul ca imaginile sunt prinse in sectiuni diferite, iar corpurile nu sunt perfect
sferice. 3 mm este limita de rezolutie a ecografiei. }{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Pentru standardizare \uc1
\u8211 ? diverse masuratori. Pentru dilatatiile renale (hidronefroza) \uc1 \u8594 ?
diametrul antero-posterior. }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 \par }\pard \plain \fi-420 \li420 \ri0 \lisb0 \lisa0
\langfe2052 \langfenp2052 \f4 u\'00\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Urografie**}
\cf1 **Permite vizualizarea intregului aparat urinar de sus pana jos pe un singur
film. Pot fi apreciate dilatatiile renale, ureterale, aspectul vezicii, etc.}{\fs24
\langnp1033 \langfe2052 \langfenp2052
\langfenp2052 \cf1 Informatii indirecte despre functia rinichiului. Spune daca
secretia apare bilateral in acelasi timp, daca exista un obstacol unilateral, daca
exista reflux.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfenp2052 \f4 u\'00\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Cistografie
mictionala(CM)*** }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 ***Sau ecocistografie mictionala (ECT) \uc1 \u8211 ? pentru confirmarea
diagnosticului de reflux vezico-ureteral. Ecocistografia mictionala se bazeaza pe
administrarea unei substante de contrast.}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 In CM poate fi precizat gradul de
reflux, ECT este doar calitativa, prin masurarea diametrelor rinichiului se
apreciaza gradul de reflux.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Pentru diagnostic : CM. Pentru urmarirea evolutiei: ECM.}
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Uro \uc1 \u8211 ? CT****}
\cf1 ****Copilul trebuie pus pe burta \uc1 \u8594 ? trebuie sedat. CT multislice
\uc1 \u8594 ? si daca copilul se misca, celelalte sectiuni vor compensa sectiunile
compromise. }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 I se administreaza cloralhidrat (sirop, doza 1 ml/kg corp) \uc1 \u8211 ?
drogul violului.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Uro \uc1 \u8211 ?
RMN*****}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 *****Pacientul nu poate sa se miste absolut deloc \uc1 \u8594 ? trebuie
anesteziat. Aparatele de anestezie sunt speciale, fara componente metalice (RMN nu
poate fi efectuat daca exista ceva metalic in el)}{\fs24 \kerning1 \dbch \af2 \hich
\langfenp2052 \cf1 Doza radiativa: }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf1 Radiografie \uc1 \u8594 ? 2 ore de zbor cu avionul}
\cf1 Urografie (5 radiografii) \uc1 \u8594 ? 10 ore de zbor cu avionul}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 CT (aprox 10
radiografii) \uc1 \u8594 ? 20 ore de zbor cu avionul}{\fs24 \kerning1 \dbch \af2
\langfenp2052 \cf1 \par }\pard \plain \fi-420 \li420 \ri0 \lisb0 \lisa0
\langfe2052 \langfenp2052 \f4 u\'00\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
Scintigrafie****** }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 ******Ne poate spune functia rinichiului.}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 DTPA
\uc1 \u8211 ? spune cum e functia rinichiului drept fata de cel stang, raportat la
functia totala, considerata 100%. <20% \uc1 \u8594 ? rinichi foarte afectat.
<10% \uc1 \u8594 ? rinichiul trebuie scos. Foarte bun pentru functia obstructiva.}
\cf1 DMSA \uc1 \u8211 ? foarte bun in reflux.}{\fs24 \kerning1 \dbch \af2 \hich
\langfenp2052 \cf1 Clasificare -}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Obstructiv}{\fs24
\loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 }{\fs26
\langfenp2052 \cf1 -Refluant }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 -Mixt }{\fs24 \kerning1 \dbch \af2 \hich \af0
\fi1540 \li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24
\langfenp2052 \cf3 5)REFLUXUL VEZICO-URETERAL }{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Flux anormal / retrograd al urinii
\uc1 \u238 ?n tractul urinar superior - Baskin}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \tab }{\fs26
\langnp2057 \langfe2052 \langfenp2052 \cf1 \tab }{\fs26 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Regurgitarea urinii vezicale \uc1
\u238 ?n tractul urinar superior - Kelalis}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \tab }{\fs26
\langnp2057 \langfe2052 \langfenp2052 \cf1 \tab }{\fs26 \kerning1 \dbch \af2
\langfenp2052 \cf1 }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Pasajul retrograd al urinii din vezic\uc1 \u259 ? \uc1 \u238 ?n
ureter \uc1 \u8211 ? Ashcraft}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 \uc1 \u206 ?ntoarcerea urinii din vezic\uc1 \u259 ? \uc1 \u238 ?
n ureter \uc1 \u351 ?i de aici \uc1 \u238 ?n c\uc1 \u259 ?ile excretoare
superioare, av\uc1 \u226 ?nd ca efect suferin\uc1 \u355 ?a renal\uc1 \u259 ? -
B\uc1 \u226 ?sc\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
Cistografie mictionala }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Gradele
de reflux}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 In care ureterul
distal e nedilatat }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lisa0 \nowidctlpar \hyphpar0 \lin425 \rin0 \itap0 \ls18 \fs24 \kerning1 \dbch \af2
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Intrarenal fara
dilatatii}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Dilatarea moderata a
ureterului, calicelor (isi mentin forma de cupa)}{\fs24 \kerning1 \dbch \af2
\hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Dilatare ureter, bazinet si
calice cu aplatizarea, stergerea acestora}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langfe2052 \langfenp2052 \cf1 Dilatatie mare si tuortuozitate ureterala, dilatatie
mare a bazinetului si calicele acestea bombeaza}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 !!!Ureterul poate fi ascuns de
hiperaerarea din tubul digestiv al unui sugar. Cand sugarul se alapteaza, odata cu
laptele ia si aer.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Ecografia -}{\fs26
\langfenp2052 \cf1 Demonstreaza dilatatiile renale si pielice}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf17 Eco-cistografia -}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Diagnostic
calitativ al RVU}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Scintigrafia-}{\fs26
\langfenp2052 \cf1 Evidentiaza afectarea functiei renale}{\fs24 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf17 URO-CT -}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Evidentiaza
cicatricile renale}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Clasificarea RVU}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Dupa momentul
aparitiei}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Pasiv apare in perioada de umplere a vezicii \uc1 \u8211 ? mai grav, sansa de
infectie mai mare}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Activ apare in perioada de evacuare a vezicii}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Dupa cauza}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Primar datorita anomaliilor
congenitale ale jonctiunii pieloureterale}{\fs24 \kerning1 \dbch \af2 \hich \af0
\fi1438 \li0 \ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24
\langnp2057 \langfe2052 \langfenp2052 \cf1 Primar \uc1 \u8594 ? idiopatic. Reflux
prin imaturitatea jonctiunii uretero-vezicale.}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Secundar unui obstacol subvezical sau in
vezica neurogena}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Secundar \uc1 \u8594 ? obstacol subvezical, fie valva de uretra la copii, fie
stricturi uretrale la adulti (infectii veneriene, urmate de sondare).}{\fs24
\langfenp2052 \par }\pard \plain \li0
\ri0 \lisb0 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24 \kerning1 \dbch
\cf3 DUPLICATIE PIELOURETERALA}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Prezenta a doua sisteme pielo-caliceale si a doua uretere
corespunzatoare, de aceeasi parte, care se deschid separat in vezica \uc1 \u8211 ?
cel superior se va deschide caudal in vezica fata de sistemul inferior (principiul
Weigert-Meyer)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Varianta anatomica \uc1 \u8211
? rinichiul prezinta cea mai mare variabilitate}{\fs24 \kerning1 \dbch \af2
\langfenp2052 \cf1 Se mai pot intalni forme incomplete si de ureter }{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Poate fi completa de
sus pana jos : 2 , 2 uretere. Ureterul superior se deschide in vezica inferior de
ureterul inferior.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Creste incidenta : megaureter, ureterocel.}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Bifiditate \uc1 \u8211 ? 2 bazinete
drenate de acelasi ureter.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 2 uretere care undeva pe traiect se unesc si se varsa printr-un
singur orificiu in vezica.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
Asimptomatica }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 poate asocia: -}{\b1 \fs26 \kerning1
\cf1 Hidronefroza }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 pe unul/ambele sisteme}{\fs24
-}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 Megaureter, Ureterocel, Reflux vezico-ureteral}
\cf1 -Ureter ectopic }{\fs24 \kerning1 \dbch \af2
\langfenp2052 \cf1 Diagnostic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf17 Ecografie }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 poate evidentia santul de
separare intre unitatile renale}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
Urografie }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 demonstreaza anatomia renala si in caz
de }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 \ul1 unitate renala superioara nefunctionala}
{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 ia un aspect specific de }{\fs26
\langfenp2052 \cf14 lalea ofilita.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\listtext \pard
\langfe2052 \langfenp2052 \f2 7)\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf3 Ureterul ectopic}
\cf1 Deschiderea anormala a ureterului intra sau extravezicala}{\fs24 \kerning1
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 La baieti \uc1
\u8211 ? in uretra posterioara, in canalele ejaculatoare, veziculele seminale sau }
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 canalul deferent
\uc1 \u8211 ? sub sfincter}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \fi720 \li720
\langfe2052 \langfenp2052 \cf1 La fete \uc1 \u8211 ? in uretra, fund de sac
vaginal, uter}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Semnul primordial
(diagnostic)}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 este prezenta de}{\b1 \fs26 \kerning1 \dbch \af2
mictiuni normale pe fond de incontinenta de urina}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 , care are trei
caractere: -}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 Congenitala}{\fs24 \kerning1 \dbch
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Permanenta}
\langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? diurna si nocturna}{\fs24
-Incompleta }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? prezenta si a mictiunii normale}{\fs24
\langnp2057 \langfe2052 \langfenp2052 \cf1 Investigatii}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 : }
\langfe2052 \langfenp2052 \cf17 urografie, CT, uro-RMN}{\fs24 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 Diagnosticul pozitiv se bazeaza mai ales pe }{\b1
\langfe2052 \langfenp2052 \cf1 anamneza}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 !}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Desi copilul face
pipi cum trebuie, are mereu chilotelul umed.}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Urografie \uc1 \u8211 ? semnul lalelei
ofilite.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Pielonul superior in general este nefunctional, hidronefrotic, produce mici
cantitati de urina.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfenp2052 {\listtext \pard \plain
\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5 \lang1033 \langnp1033 \langfe2052
\langfenp2052 \f2 8)\tab }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf3 Ureterocel}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Dilatatia chistica a
segmentului submucos al ureterului intravezical }{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 La nou-nascutii de sex feminin
ureterocelul poate prolaba prin uretra}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Produce }{\fs26
\langnp2057 \langfe2052 \langfenp2052 \cf14 obstructie}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 \tab }{\fs26 \kerning1
\cf14 \tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 \tab }{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 ureter
dilatat}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf14 \tab }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf14 \tab }{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 \tab }
\langfe2052 \langfenp2052 \cf14 pielon superior dilatat }{\fs24 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf1 Complicatii: sepsis prin retentie de urina
infectata}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Diagnostic pozitiv}{\fs26
\langfenp2052 \cf1 bazat pe:}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf17 Ecografie }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf17 Urografie/cistografie}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ? }
\langfe2052 \langfenp2052 \cf1 \ul1 defect de umplere a vezicii }{\fs26
\langfenp2052 \cf1 +/- rinichi in \uc1 \u8220 ?}{\b1 \fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 floare
ofilita}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 \uc1 \u8221 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0
\hyphpar0 \lin0 \rin0 \itap0 \ls19 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf3 VALVE CONGENITALE DE URETRA
POSTERIOARA}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Prezenta unor pliuri semicirculare ale mucoasei uretrei posterioare, care
realizeaza un obstacol in calea evacuarii urinii, cu repercursiuni asupra
aparatului urinar superior. }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
Uretrocistoscopia }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 permite atat diagnosticul de certitudine
cat si tratamentul curativ}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
Consecinte }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 : }{\fs24 \kerning1 \dbch \af2 \hich
\langfenp2052 {\b1 \fs26 \kerning1 \dbch
-Retentie cronica de urina}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 -Elementul patognomonic este }{\b1 \fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 globul
vezical }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 si }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch
\f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 jetul urinar filiform,
intrerupt}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -}{\b1 \fs26 \kerning1
\cf14 Vezica \uc1 \u8220 ?de lupta\uc1 \u8221 ?}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 -}{\b1 \fs26 \kerning1 \dbch \af2
Deteriorarea mecanisului antireflux}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf1 -}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 Megauretere}
\cf1 -Leziunile fiind bilaterale conduc progesiv la}{\b1 \fs26 \kerning1 \dbch \af2
insuficienta renala ireversibila}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\cf1 Examenul imagistic: }{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 -Investigatie de prima intentie : }{\b1 \fs26 \kerning1 \dbch
ultrasonografia ante si postnatala}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf17 -Urografie}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf17 -Uretrocistografie mictionala}{\b1 \fs26 \kerning1 \dbch
(examenul ce precizeaza diagnosticul)\uc1 \u160 ?}{\fs24 \kerning1 \dbch \af2 \hich
\hyphpar0 \lin0 \rin0 \itap0 \ls19 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf3 NEFROBLASTOMUL(Tumora Wilms)}
\cf1 Stadializare imagistica!}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf9 Stadiul I}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Limitat la }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 rinichi}{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 , }
\cf1 Complet rezecabil\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf9 Stadiul
II}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Extins \uc1 \u238 ?n afara rinichiului (}{\b1 \fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 capsul\uc1
\u259 ?, noduli limfatici regionali, ureter}{\fs26 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 , etc.)}
{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langnp1033 \langfe2052 \langfenp2052 \par }\pard \plain \li0 \ri0 \lisb0
\langfenp2052 \cf1 Complet rezecabil\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2
\langfenp2052 \cf9 Stadiul III}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Extins \uc1 \u238 ?n afara rinichiului }{\b1 \fs26 \kerning1
\cf1 (metastaze peritoneale, noduli limfatici paraaortic}{\fs26 \kerning1 \dbch
\af2 \hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 i,
etc.)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\i1 \fs26 \kerning1
\cf1 Incomplet }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 rezecabil\uc1 \u259 ?}{\fs24
\langnp2057 \langfe2052 \langfenp2052 \cf9 Stadiul IV -}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Metastaze
la distan\uc1 \u539 ?\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\cf9 Stadiul V -}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 Tumor\uc1 \u259 ? renal\uc1 \u259 ?
bilateral\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\langfe2052 \langfenp2052 {\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \af0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 {\*\shppict {\pict {\*\picprop
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\picscalex187 \picscaley187 \picw402 \pich187 \picwgoal4020 \pichgoal1870 \pngblip
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Diagnostic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 50% din cazuri \uc1 \u8211 ?}{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 forma\uc1 \u539 ?
iune tumoral\uc1 \u259 ? abdominal\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Asimptomatic\uc1 \u259 ?}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Caracter}{\fs26
\langfenp2052 \cf14 neted, globulos, renitent, nedureros, mobilitate
relativ\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\loch \f0 \lang2057 \langnp2057 \langfe2052
\langfenp2052 \cf14 Hematurie, anemie, sc\uc1 \u259 ?dere ponderal\uc1 \u259 ?,
inapeten\uc1 \u539 ?\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf14 Durere, febr\uc1 \u259 ? }{\fs26 \kerning1 \dbch
\langfe2052 \langfenp2052 \cf8 ruptur\uc1 \u259 ? tumoral\uc1 \u259 ?}{\fs24
\langnp2057 \langfe2052 \langfenp2052 \cf1 Imagistic\uc1 \u259 ?}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Ecografia
abdominal-}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 Localizare, origine, extensie
vascular\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 CT/IRM}{\fs24 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Confirmarea diagnosticului
ecografic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Extensia tumoral\uc1 \u259 ? (metastaze pulmonare, invazie vascular\uc1
\u259 ?, etc.)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Markeri tumorali}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Nu exist\uc1 \u259 ?
markeri specifici pentru nefroblastom}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Markeri pentru excluderea
neuroblastomului}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 11)\tab }{\b1
\langfe2052 \langfenp2052 \cf3 Testiculul necobor\uc1 \u226 ?t}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Diagnostic}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 Absen\uc1 \u539 ?a
testiculului din scrot}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf14 Hemiscrotul nelocuit}{\fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8211 ?
hipoplazic, retractat asimetric}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf14 Hipertrofia testiculului contralateral }{\fs26 \kerning1
\cf1 \uc1 \u8211 ? semn de monorhidie}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Poate fi }{\b1 \fs26 \kerning1 \dbch
palpat }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 \uc1 \u238 ?n canalul inghinal sau ectopic (regiunea
femural\uc1 \u259 ?, prepubian, hemiscrotul contralateral, etc.)}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Caractere sexuale
secundare \uc1 \u8211 ? neinfluen\uc1 \u539 ?ate}{\fs24 \kerning1 \dbch \af2
\plain \li0 \ri0 \lisb0
Imagistic\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf17 Ecografie}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057
\langnp2057 \langfe2052 \langfenp2052 \cf1 scrotal\uc1 \u259 ?, canal inghinal
\uc1 \u537 ?i abdominal\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf17 CT/IRM}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\cf1 Laparoscopia exploratorie }{\b1 \fs26 \kerning1 \dbch \af2 \hich \af0
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 -}{\fs26
\langfenp2052 \cf1 Testicul situat intraabdominal}{\fs24 \kerning1 \dbch \af2 \hich
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Diagnostic\uc1 \u259 ?
\uc1 \u537 ?i terapeutic\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langfe2052 \langfenp2052 \cf3 VARICOCELUL}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Cauze-factori favorizanti?}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Incompeten\uc1 \u355
?a valvular\uc1 \u259 ? a venelor spermatice interne}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Compresia venei renale st\uc1 \u226 ?ngi
(pensa aorto-mezenteric\uc1 \u259 ?)}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langfenp2052 \cf1 Secundar \uc1 \u8211 ? tumori renale, tumori abdominale,
hidronefroz\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
Diagnostic}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 Majoritatea \uc1 \u8211 ? asimptomatice}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langfenp2052 \cf1 Simptomatologie -Senza\uc1 \u355 ?ie de \uc1 \u8222 ?}{\fs26
\langfenp2052 \cf14 greutate}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 \uc1 \u8221 ?, }{\fs26
\langfenp2052 \cf14 disconfort }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 la nivel scrotal}{\fs24
-Aspect clinic de \uc1 \u8221 ?}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf14 ghem de r\uc1 \u226 ?me}
\langfe2052 \langfenp2052 \cf1 \uc1 \u8221 ? la polul superior al testiculului.}
\rin0 \itap0 \fs24 \kerning1 \dbch \af2 \hich \af0 \loch \af5
Imagistic\uc1 \u259 ? -}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Ecografie scrotal\uc1
\langfe2052 \langfenp2052 \cf1 + }{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf17 Doppler}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf1 Clasificare}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Grad 0 (subclinic) }{\fs26 \kerning1
\cf1 Nepalpabil Identificabil doar ecografic}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Grad 1 -}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Palpabil
doar la manevra Valsalva, cu pacientul \uc1 \u238 ?n picioare}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Grad 2 -}{\fs26 \kerning1
\cf1 Palpabil cu pacientul \uc1 \u238 ?n picioare}{\fs24 \kerning1 \dbch \af2 \hich
\langnp2057 \langfe2052 \langfenp2052 \cf1 Grad 3 -}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Vizibil}
\lang1033 \langnp1033 \langfe2052 \langfenp2052 \f2 13)\tab }{\b1 \fs34
\langfenp2052 \cf3 Hipospadias}{\fs32 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Clasificare -Distal \uc1 \u8211 ? glandular, balanic}{\fs24
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Penian}
\cf1 -Proximal \uc1 \u8211 ? penoscrotal, scrotal, perineal}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Deschiderea anormal\uc1
\u259 ? a meatului urinar}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\lang1033 \langnp1033 \langfe2052 \langfenp2052 -}{\fs26 \kerning1 \dbch \af2
\hich \af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Fa\uc1
\u539 ?a ventral\uc1 \u259 ? a penisului}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp1033 \langfe2052 \langfenp2052
-}{\fs26 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 Oriunde de la perineu p\uc1 \u226 ?n\uc1 \u259 ? la
gland}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Penis \uc1 \u238 ?ncurbat}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 Anomalii prepu\uc1 \u539 ?iale \uc1 \u537 ?i/sau scrotale.}
\cf1 Diagnosticul malforma\uc1 \u539 ?iilor asociate}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 Testicul necobor\uc1 \u226 ?t}{\fs24
\loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Malforma\uc1 \u539 ?
ii renale}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 Tulbur\uc1
\u259 ?ri de diferen\uc1 \u539 ?iere sexual\uc1 \u259 ?}{\fs24 \kerning1 \dbch
\af0 \loch \af5 \lang1033 \langnp1033 \langfe2052 \langfenp2052 {\listtext \pard
\langfe2052 \langfenp2052 \f2 14)\tab }{\b1 \fs40 \kerning1 \dbch \af2 \hich
\af0 \loch \f0 \lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf3 Fimoza}
\cf1 Clasificare}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 1.Fimoza fiziologic\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 2.Fimoza patologic\uc1 \u259 ? (balanita
xerotica obliterans)}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 -Secundar\uc1 \u259 ? unui proces de cicatrizare}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 3.Aderen\uc1 \u539 ?e
balanoprepu\uc1 \u539 ?iale}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0
\langfenp2052 \cf1 -Imposibilitatea decalot\uc1 \u259 ?rii glandului}
\cf1 -Absen\uc1 \u539 ?a inelului de fimoz\uc1 \u259 ?}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf1 Complica\uc1 \u539 ?ii}{\b1 \fs26 \kerning1 \dbch
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 Parafimoza}{\fs24 \kerning1
\lang2057 \langnp2057 \langfe2052 \langfenp2052 \cf1 -Imposibilitatea recalot\uc1
\u259 ?rii glandului}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 -Gland decalotat, inel de fimoz\uc1 \u259 ? constrictiv la nivelul \uc1
\u537 ?an\uc1 \u539 ?ului balanoprepu\uc1 \u539 ?ial}{\fs24 \kerning1 \dbch \af2
\langnp2057 \langfe2052 \langfenp2052 \cf1 -Edem la nivelul glandului, ulcera\uc1
\u539 ?ii p\uc1 \u226 ?n\uc1 \u259 ? la necroz\uc1 \u259 ?, reten\uc1 \u539 ?ie de
urin\uc1 \u259 ?}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033
\cf1 -Urgen\uc1 \u539 ?\uc1 \u259 ? chirurgical\uc1 \u259 ?}{\fs24 \kerning1
\langfe2052 \langfenp2052 \cf1 Balanopostita}{\fs24 \kerning1 \dbch \af2 \hich \af0
\langnp2057 \langfe2052 \langfenp2052 \cf1 Inflama\uc1 \u539 ?ia glandului
\uc1 \u537 ?i prepu\uc1 \u539 ?ului}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch
\langfe2052 \langfenp2052 \cf1 Eritem \uc1 \u537 ?i edem local}{\fs24
\loch \f0 \lang1033 \langnp1033 \langfe2052 \langfenp2052 }{\fs26 \kerning1
\cf1 Secre\uc1 \u539 ?ie, disurie, s\uc1 \u226 ?ngerare la nivelul prepu\uc1
\u539 ?ului.}{\fs24 \kerning1 \dbch \af2 \hich \af0 \loch \f0 \lang1033 \langnp1033
\cf1 \par }\pard \plain \li0 \ri0 \lisb0 \sa200 \lisa0 \nowidctlpar \hyphpar0 \lin0
\lang2057 \langnp2057
\langfe2052 \langfenp2052 \cf1 \par }\pard \plain \li0 \ri0 \lisb0 \sa200
\langfenp2052 \cf1 \par }\pard \plain \li0 \ri0 \lisb0 \sa200 \lisa0
\cf1 \par }\pard \plain \li0 \ri0 \lisb0 \sa200 \lisa0 \nowidctlpar \hyphpar0 \lin0
\ri0 \lisb0 \sa200 \lisa0 \nowidctlpar \hyphpar0 \lin0 \rin0 \itap0 \fs24 \kerning1
\langfe2052 \langfenp2052 \par }}

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{\rtf1 \ansi \ansicpg1252 \deff0 \stshfdbch2 \stshfloch0 \stshfhich0

\deflang2057 \deflangfe2057 {\fonttbl {\f0 \froman \fcharset0 \fprq2 {\*\panose

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