‘40 _Medicind interad penta cadre medi a a boomin en Gene De gtr ence it nape ete eran See nel pevroze astenice, cu astenie fizicd gi psihicd, insomnie = St oyna, efile eel. La Tome seinen a oa emake late ma pace acne iver Lachane oa discret hpercromil winae puagere.Conchusies save lspeptic, intoleran Ia grisimi si dure abdomioale, _S44 Medicinl intern pentru cadre medil a eee a... nears: — oe diagnostic. El poat ere ca eee Smee: ae eee on eee ‘Dagmar sac ca lea aod, pancetta re, rn co epi coi . ‘ols ee ler da poate fei de puscur sobs sis ciara Reset repli eV dale pote sigur ove ‘herbi ev canpleaile Gnpl sect c angaol at sn cron icles su vec ponte tse cancer, ipa Bea, hepa cones ‘Sie (ln), pncetittomns ves pore. Pema crs peal ten dria coll pu sb ek Trtament i clea ronich oi, adn tapes vf ces cpl Lita iar” Colin ci eee bec nee etemumenl aca cl cle i ap dared cu ste ng ‘nese telnet eagven sss ives compli Repeal estas Severevineforunle mar fey tlc vine detonate seh {ntehinh exci ice jou Dia claenl dba al tae, il Stu ewe comand itn ilar Reginald Se ‘onanif 43 mea se ume spe nl ny bir scr “ipimad core veSmalsvrlnptnde ose desolzre In gee! ‘vor 6 evita alimeatele prajite, rimtagurile, sosurile, maionezele, mezclurl. ‘Monin, trestle pa ferment el tra, ut de pot 30 ‘este. ste tl rnb moder de ng era (3-4). pon eis ‘re evle de mise save eporunb101Se dmc penne. Sle pe id Se maladie Salt gnc sa eo, 22 6° souteipe Sorbie 25-5 garter eames comand = ‘Gejei nett Amol, deat rome! Kein) Mesocapr Spaces Gere eames! Om -2peah scone atom rato af! ———-- ai oe wou pec a ape Amelia Gare aise Ec oar lyse nomaeent 33a de IB G20 rinse sins dmc Sosere tn Mearns lot Meliss rece Co obi Bolo Papel Ang. Aopen Seno, Papen ev ml [Besta rin inanclspia Lue Ont), Deco Seger tors femestepncreae (ierment, Menus) 2 {Etna Tce atone reajseunceastocaze sept introduce pe sonda gi antibiotce(Streptomicing). fa Geadepnn bcos suns rues Agel Soave lh ab Feeeapica asinine or Saree nel ela Mette leeir cases octyl nec Soyo pote tlie feted tric uses Can pt ical roan (nerd parntarcor nhac sac Sng: Suede Ca Trane cnt ee ind cing we oper ss sed Peepcnmptc onan semanas ‘6.7, Diskinezile bliore Se Hosea ire suds hore Ate wr ote ok he ea Sesssrumeti utr Nsdnpontae np oonaae eae an Se fo nto cen ema opan Beste crore» fei (a hepa veh aaa oe ene Saas volun ison spepci natn consumo ds chosen, Sit racic ys ica penal eee ea loa ecou sivas docomentr sve fe, im! Oi; oman! ¥ moins dea aes epost ccc Dane er uni nna mos dinve, erent ee Bar tm Dues GncuntetuiceRaere m fess ae nna gut-plie dale an tae sebazeaz pe fall voluml vec billare varia tn diferite cm noma vec Ne eu rp ela atop acon cee bun eoledoc bine vicibil. ee nes loc Spm ee sete cave eco len Var age sli hpi vse ee cain euro sacn Oi een a ‘es Mosk sich earn shyt Ses. eee k eee... era ete ni tment eet coe ee ere ae Se = cae TT re ene ee een Sa ate ra reane rome ho ee CSE es Sea ees —— eee ee Cs Se ee Sree es ee eee ane ee Sete ace enet eee = gran dint ceiver peer oe pgp peter repre Saba rcetoneerereeamen i oe -Cvezicull lupeitoare”). : ‘Spasmul sfincterulul Od este, de asemenea, legat de hiperexcitabilitate $! aS mtr ecm pr» eon Bolile chil bilare _ $47 daca ch Lacan abies veel dein ine ipl Radioscopia duodenal poate decela mextificares tranzitului gi vii migedrt Mpc, Colson a ran pcioen cana hepatic Ghracealsorinrsbpatcs iin enna pineal Boyden Usps cons! Ot cons) en deseo nt clei Spa space vir $s muni prin dane periadlt ponpridial Simei scan sts sori (hn dood pune nile en Srel decis) La radscopi ducal sot oacva cee usta (eesti wl Vc Corstopna pa gna amie veel — epaelnetia prone deena sac or co veseltperion, pai. Trtamer rin ln, npc feu oe pou nie lesen vs inc ama econ rei eos leh Teese romano ics cosine cu acne cles finery So ut usc ann caret, Camedicament fee inna pescnat linge la naar dar als Hagens Cac, rohi, ghol Cat aldol, Popocain Tijd dnsenle epate da rest bu, Tn genera auenal est Blick erent iClear Inport vcr i liners oso ml ile nerctdnd seem de og Pas. Cacticunen se pers aspance olaen, fbn, Lisson, hNseeple) nt Pvlong Apical decompres scott posed eps acne cman Ese meee ecloss etary sete cine me imatrck Spann sinc Ora impun un eg tae Ti aimee ane yb ec Maden coma leslandoinergct nil Penlopal Drenabion ewolpicle ancien comple trent neces Oa puna pin aliments Youn chide jen spine ie vimine dane een vor setae il canes cuca gral Se adnan oa ih Lian Hearn Ss, Bucopen, Prous eat {Sal Coll, Pepsin ce) scare (Semone 1c) eine (Dany ion, Mapa Renae ehralnv coda dd dat scapes medal da ut srs apotundad Races ne peste, ago leonomieranda ak ution. Sn is abot nec nerve ches salitatvecesensfex asm ope eg7. BOLILE PANCREASULUI 71, Nail de onto age ‘Paarl et un orgs andl staat eoperioeal, transversal lc incor ouverte lamar. lr i pli capal oral cond, cpl esc [teonat de pteonva duodenal ir coud merge in a pid. Pant are dou ctl exretor, canal Wing (picial) stra vali ongal lige dechiefn ode la ampulai Vater unde ewe acoledoa canll Sato (ascevoris) ere poet in carl Wisin ‘vt cops desc n duden, despa arpl!ViterRaporrie sts ‘cna Wirmgevcoledoul aso desebisnporaiainplgie. Dinpun vedere holo, pancreas ee ales din dus pl: panereasil ect. eosin cn eg deetalele eerie pancreas endocrine i ine Langerhans, ipeat fn fsul lanl In insu exst ova flan ‘se: cll a rama eps, clule ca gran deschise, east isla, Pancreas exori sere ferment digest fae activ, sre lor find rma de ingen alimentlr influent de casita gi compos ‘csr Is fina ec a pancreas itervine wn canis relator nel Immoral Ps deo pre, secre pancreatic est infu pe cae sanguin scrim duodenal ape daa, soar cereal ner i eee pret: in real pervoaseviscero-corteale i conic-ssceale.Sereti eee = pancreas suc pancreatic exe nlc incl, eureka care en ‘ei fermen psi, mz asta. ‘Tigsina ete un fermen prota activate wsinogen prin enerckinz> nestle comin digesta substanor tie (cept nsomac) pn alpen amin i coder nile ai oli lbarnns. “Anca ss dastea eto enc oar ctv, care tar don ‘aoa ica va fantom rnd, de mala n gco, pea tevin sapoiieare gris, sind rising 9 ‘igi cae formese pana cus dia seinen. Aejones lip ‘sm grime aloe in prezeie| endocting, ‘rnc: omenal nei gucagonal Inne 3 aun rol pepondce! ‘iol pce infra cba pin lp! ote pancreas 1.2 Not de serie Inti oo och bie resin cma even toma eattelr nboldvinle st eso secundare,ae pen are (Manne om reer cc nod yeep ole {Siebel tie asada are sepe, malaria mele fet nections ra ih heat pec, parti epdemic). Tebule Ceca snroml septic pacrestic, crc. pin anorexia dpe, fn scam oft fervent de pease Fou rar sefnetblimi ie dare csc sind pons a ihe gtene-Pcoes, comin de sins, amicescop ead Pre musclarec pute ina, cust Piste picttur de grime new less tales epee ote SL {Reps momo nentear occ sipetviene Dwele sunt lens, eel, fuse epg, sprout ope ipocondrl sng iba Hemioeshi ng Cite para ce Tote puters, ov rath de 2 le Spon descr sinpome dierent defame, stare de einige tbr nur pce tear samp char conv AC, Suvi fenomene de poislnim, hpergliemie plore, ear nse Iban sro exer. _ Sonne oblcve anspor, cle mai mle oy emme case Ae stern puncreaee torn ets ds inti in bolle pancreas ‘lord proceso deferment de ptrefaci cxagea.Cmpreiuen ela ‘col panretice ete dco no de compres concomene pe tle ‘la nr ili) p es or (snore pe vera asain (em Alenemearpelvine) sau lea sar (arr exo de olen e enomene de "3. Exploeree fenonolé © pececseli “angie materior eal exe unl dnt cele mai i se praetct numai ula fost ses timp de ile uni regi de pri Sch einai pancid ete scopic 0 mas ai isn cone ove snes: signa Ls caneh ta rie inn ct ci mar ee (Gre retire de mabe eee meson ra oe Se ci pat) fe care cus nce gece ake se" ilar wre gal ger eng fmt pce a dn ag ccm paral ama heal ata Sear mrs st nel psn50 Mod itera petra cadre med aT eas tien sere reas neem ect eevee beeen peasant ene ieee oe ees em Sc ra a ors Smee eee ta tees on sees es tw pict as ee ease a ooo nee! re eenn: Ce tere ease ede ea a ee ee ae eee a Sr Se 1a era ce Ceo So eee ee ee Se en esa scat oer So ee ae ee eee ras an ee eee petit Ee ee ee Semis eationtemneteesa rin: ae eg: Sa ‘rif ei aoe te ig Vdc ini {FEE el Aten peacoat lop ne Son te pe pnt hmong ee a ame sie ues un diagnostic de prcize, ci doar de f° Sienna pena ih ~ gts sst Bote pncreaseat_ poe deine de bsl fundamen yd bis este Du Profiatasecontni cu vce bollorcaces ois de pncreatis rr To ort cS Tpatamenna cuticle erersna de ratamenul bi fundamental mig ponts crear ariel fucionae parent, 15, Penceaite oat henerag Protests acu enocgch este unos sb donumirea de paneeati ath bonergie nero pret cats grav, pacreatischiregicals a HeMpunreae,stesonccozh pancretic, Uni auton recunose dous tip demas 9 necrozn Mgt secre» pocreanui cu career aati drama, provoett de let ohenatonse hemorupic i nscrotic Degieste denumi pancreti terai~ Aap impli ont inl, ptind sven afr orieBat proces faa ( exempts nt! paces) Bolo xe corplens vache Inca ncaz Boal se manifest fnte 30 iebdean cu fervent mina ize 359545, Tac ctlogedeterina sant oct» situa care provoae refuel Ili panccas ere cre uc ferns doodena pancreas; obser hallo panctstie; accident leant vascular. Factor favorizanf sunt Sherine alcool, sbuzuniaimentars, ara bir, infec dlr bare, ett croie, aber sleerl dndemal, pend, bol neous hepatta ‘pide, fob ia, ‘tologiifieoputlopa suntpaia clare. © veg important sre aetunen sell pacreati pe land (produce necrort merging pt la ischeril grav). Darsucpanreiarsonar| sacle vce nduclndcongestiahemorgich Apmetestl, Apa atl un cere vies de nein, deagravare pancreas ulna mergind pd lanccrozh. Alt aspect exe ereierea masiva de peptide curl Inoreereanfamate. Tees aoa chsruci blr, efor represent de ‘etl omit care ree ml presses oel raumtiin prundeea bln ‘al pancreatic. Acjoneaza st cuzele metaboie: oll metabolioe eu bros ‘Site rena, hiperartioia, bemocromatoza duet bole heptce defiite arin ce se pot nena reciro) aria, taumatisme diverse, nf medanet clrosazide, lool tii, tural taps polis, teromatozh pancreatic, ulcerl penetant, erediaten, renal epitevine Yoel, cbziate, aura aimentaren special ‘Aceta sunt factor Favorizani. Pectoral determinant este rela proces fiopatoloic al pancrettei hemoragice i necrotice const 8 fermenilor pancreatic! intraglandular’ wmatl de digesta planed In declangrea sei inervn serie de factor: meselecopoase, alr colic bare, eines tamale abdominal i eilogic pe primal lo se sacar itaza ir, et cen cola52 _Medicind intend pentru cadre med lank, Apu la ome! a propone de 78% dine azar (cai taza iar, die ace even). Alt factor etiologic important este ingestin acu, conic de loo Ia fig nerve chrurcale pe abdomen, austin ‘oni hipetpidemiajonc unl elo, Labbe predomi also fone ie Patogenia proces fciopatolgic pe cre se bazar apis ps cell aa amorapice aecotieconst in artivarenfemmenor pes ‘nmgudalr, arma de cigs ns alan (aodigesti)- Lert cons Inpances un eden emoraile, once de cotetonecrozi si pra sa De obit exit oud tpar de ein edema eens homage [praia aceste prez doud sta cu grote cress ‘Ema pure forme ca gravitate mn reds, lr ner in armel ser CGostesonecroza ape n fomele cle mal grave, Debut ete ras, ‘Semae gnve,alarmane, canoscute sub mums de “dram panera sin ‘recon in des epigastie speciale, eo violent necboui ssc ‘mbolizate, esi cu rade dre In stg su erosiemal, nor ss poco dept Dreea reste api in intense, bolas sh emia ns Viral reset sou suvia concomitent eu dures pot alimentare, bie ‘sepsnase, more sau porace. Abdomen ese alot, sip tjl superior, pring sau nao woarb ape muscla Lapalparc eco uous sensblat epigastric sa o sensi ma pronu nhipocon| ‘sing, nial sistant oretenje de fecal gaze, penta ca aires ps miles eu peritoit. Din rimele ore pn a douse se pat instal 0 tare oe: fces ts oh nerd, enol, nas ja, aspire pus mic ‘apd schdere ensure (maxim ab 90 mi), agiatie conic Fehr: ¢stemodea (372-38). Principal simpome sant ere cutsturie cine: specifies, rule visti simpiomel pleural Map pie bri anz ispnee i lhipee. Uneor fo, maute subi, La examenul ing se ‘onsathipeeucoior, calor inte 10000920000, cuneate hipergice (salen prinete 24 deo iperolesterlemi hipocalconie. Amira angus «stcrescut In primele ore (pn a 36-4 deo) pala vlori de 800-1000 ‘oblgemut sa pnt a 800 Somogy arin lle unitate sede Nivea ses al lpes este moi speci. Mat. ipl ah oa : et so fae psc elu eel a sino ore 6: ants pee Ba hand bt ee eee ne ee see a ra eee reas ee ee ee oo th ee ee ee ee et ee ee Speers Pee ee pe a ae tn rimel 4 5 ese interaieaimentaa pe cle orld, Oath rene frp linear cliche cn (900- 400 sr. Uterine wes age en reduce sce gate i pacreaice se prescie 03g dn 6 n oven peruse soi gucoea 3%. Sea po ProsBantine,Neopeplsan.Dup ween eset, ceca ‘i exact de bldon, im mci cu solu Bourget DatS4_Medicind intra pentru cadre medi ee ....,.,. eee eae ene es, eee SS eee eterna Poems pee ns ee eee oe ee Sere oes er ea een ret tn ee Sn ee eee Sepentoneecn nett saree as ee —- re... scape eae tiem to Sarai Sere See a oe on 5 oninoe dai (nr ete cotangent) eu Fora Pex eid (Magn), 00 mgim sae Poss pers dos ec 100 mi), Atropini, Scobuti et. ‘. | a aot boeAni a or! Gentamicins 80 ‘se aorta tone mca seen (rita cron proprio cae evoliia exe ernie progresivs, fh erze Moti, Se dvele $0 pancretid calejanta Forma recureth are 0 etiologic Aeerinsarepncratitl acute pe pm plan stands iiza bara Coles fet, deter oprete voli Pancreatic cromice wnt, de bie, secundare Ral organelor din vecinfate, ele ind mai totdesunaasociate cu alt aft Freveniaeste greu de apreca, dari iceitudin diagostiul in foarte multe Si dar dite secon pancreasus, forma de pancreas conic este ce foal frecvent;apare mat des i brbai,indcosbi dp virsta de 45 dean Paver cronice se ascia8 mn ales cv ual afetun: iz iar, palit, coleistopati, bald uceoas, cree, hepatic. Destl de fecvent onic est dtr rnin pncreatilor etre din curs bailar faeroase (parti epidemic, hep epidemics, fbr ifoids,septcemi fl posi transforma in pancreaicrnic 0 sestonccrzs pancretics. Alo Fumuleroni exe un ator agraant In spariipanceatitlorcrnice pot interven fiir toxic exogeni (x mai recventslecolismul), toxceendogene (are, {aco lrg, lientar, bo de nti iabet, plage), caren vtamiice, bal eclagen El, pe pina pln se stu do fart lcoohaml rie (Fan, Tala Eien SUA) rain (dnuriiaproteie),prezeni in Asin Anca Simpiometologiapucteaitelor erence ese comple, ea depinzind at de fulbue fini pancreatic decoelaile morfo-funcionsle le pancreas Sionele vecne, iy de ubareneuo-rflex; pe dala pre, pot predomina Iulurile exocrine or cele endocrine sau pot coexists ambele, Tose scenes ‘eliza sindrom pancreatic conic consti in Manifest ispepice anorexia de grim refri,vestrh, meteors, ‘ales are i constpaicaliernd respi urdt mlrosioare,ssonce, = Dureile pot aves un earaccr constant, interpt de exact, so crizle thrstoase po aera cu ptcade de acalmie. Crise rerose spar ntesult de ‘esi ests cu prinzurbopute sou dupt consum de alcool Dunees ste salt inepigain, -aractrsicadurere“in batt, aad iad variate spe sting, uml sting, pre stngacolaneivercbae,peconil san seria dureroos este nsf de paloare, xt‘, tangy emboli pot nbc fe forma pera s pti, ranspiraireci, senza de fame, ea hiponslinsmal ou pesosos i flea hiponsulnismli fst generale a dint: sabre accenuath (fii pancreatic”), idemicd sensible tn zona pancrea- arr palpare ub rebordal costal tng, marr onoatane56 _Meaicind intern pentru cadre medih Esmond brat: examen copoage a sca de ferent, se pci, une cole, confined rest alent. La micron ‘heen gms aeue debit cite ci rag ibe maria = ‘ne (ecnore fi create). La eumenal singel se conta mei feo ‘czalbalnerrca pancreas colangiopna angiopafassea a sero posta dem pencinck —" vol panceaie con et ee oan Bo ats ore, so en oe ee cep concn es eee ee sc Se ns Ss ie ce ane a Stead retamental ue: Bite euare, cu ietericeren dfn alcool, meslor copionse Began rs ecomandares de mese mii eevee, cu aport mat bog In rssng 15 (clorivkg corp scuredacerengriimilor stb 6O gin 24. oe. ombatees due prin aniclinerpceScob,Pre-anthin, ei eompi- satepezi, Algcalmin seviares opines. s eoecares insulin parcreaice cu exact panremtie (Tiferment, GGoszy, Festal, Nuicy cc) ansaid blocante respon Hy (Cimetdi $1 Ranting, cx o jr dc ot naea melo, “rstament cirri. ofrmele cu der intense, cre ms eden a trate smetel media core admins. Traumental chrrpical vt uneoi neces ia [creaicleconice insite decomp Fe Oe a en: es... ee os ar ee [a eee eeepc ‘Gebetzabarat, tics biiard alcootul,cafeaua (neconvingltor). 70% sunt localizate : Pancreasului, 85% cu invazie locald sau cu metastaze in momentul, oe ana ee a ian Sea Tee oo See Se ea aerai se de “renin” se ponder nse, ‘Sen ud Insel un se cmos idol pe = ‘Soaulogn grovel ap sence eternal ter cane ‘Scena capper eprops ving.) insane ipitde er meron epg raingnregea ‘STi dg ncaa copper Flor ure rm ets sr maf pric ‘van on, date pte sie eg ev gra ‘a Tara nan prone caer press ‘tpn loomece cline proves de metmste sa de fs scons Dara rn rob parsing nc sat siromle rj. La cess dang use See ‘sie, ba trl pss a eres, ene au ery Sc Heep, tilde iar) pleas a. ‘cnet zor snl inva) toi te Vesa irs (ern Cure) au eeu de esc ‘rane redo nran Sas tl vod et oa ea examen rtologs ups sae lien germ tes came. ‘Banenee delaborsor pt vei aemihipcromieeacoio ‘ea vier de edimenare etoile, diet ale fener paces soe rin scl oda (recuse tale edt si ‘suc ode). Incncerl cael de pce er manic se cadres te iiubinenit (ibis die le fran ane gale oleh ‘srabiiogenl eae mul. Peo paiawes dag sunt core ur ‘rane spinenaranesogafatn es onapmfa espa is ‘vole cancel de ances disclde a fn pi a neaeo ‘ee provocatl ecomplsi sa de eae tint Diagroial ee diel in sal inal cd sindrmeldapeptic si sees ‘seer pot abut alo afi Este mal fin dif end pos a fumare sa ind aparece Examen radlope eld abort lone rol ingpontnl. Pedr In prete,igpetes, sical obatuctSr's> ‘pips sont foarte sgesve px cance, le explora \s ea Pere, Celle exp Bolle pancreas 559 —atte pertonen Sens eno oe avin (ict wim brine ea su oe afl she tpa c genl ae eo eal) Tse sce resin spo eeipe Sabena! aru! medica se itlnete io pancreata aut, gsr i hepetta Typo seri psviene inflict omoragi reroperonal,crze de ert Bako sb Ie Aone an em ne lnc acre pri dee bd Beltre rinse seme cae ep urd prt Dery eens rua par ul ace ota a a nae Fett. Cle clear stoma ochre, ees Peal de wares ignore Sy chara eet gere | SDeours sr cing org, via nau deine de fl ceettaes dager opin eecraed ayer pecje sins lier oe 0 poses, eae exit me prodomh Healey pon tact bc conic, tcoare tu anncetete (on etree net ce ¢ prin). Tel pct Bt Ae teeny pn erp aa presences pu eee bude de icon se pote psi el ct out taal ipsa aes pecrue ord ses opm ca oars co claeppeetbepcnbentl pees Bisel te tonces le agree: ces demarcate pas Beee cheep re pte ar ee Ore eee ate re er ceed Se de Fcc oleatr pent ceil let le Fes dre cis cleaners nga Mortal sel ore abr te, st olay ex ep cintomtlga ssc inl spall fal rant provera de ne gee ite, peritoneal find inet comer sal stn (pneu ‘etn fee cen pee eee ced dingnosticul tues nee te Formele comune, event fe abdomenall cut: functionale: ° ‘ett exp tue ie Seta on562 Modo nea petr endre med vin; nn linet xii err abomial e mani pin lien aol" ass pres a Ten secrsimptme, meth dings depron Semen obi coats ms te el ma important se fk sigue ces pen dag epi shen) Ee snp ds ‘bal ines Exe lets genet: a Szperial vt mil pn potunde typ din sun ence Seishin rama ret pnd nots Cd cnr ‘cule coma dvs iets bia Spars ‘eco Aptic mana re sccy smi coarse esd inns eet gear mss a pc pron ‘Shp hr pe mapper mobbing od nee roree oc as oe ‘cerbeazi durerea;, oe se pte ods contac pte int sai. etna ee mami he de, Tl ese Se ops es led pot psn cal iflrpeteno ogrslonml fe re ‘ptr Area mal pou ei aps plato ee msec ‘oe cipal een O mene calc efi ‘inti eatrpisteprtl tonal Cnt macau) pane + linistea abdominal, ca i. eth a : “force arcmin cman Second ope cena oe ‘cl fo alae eve Somme tgeag n = Merc cna dps fre ps ati ootdenana eu recta. Durer ‘undue ae Dovgian, laprlpares once de bembara impstae local sunt preose smn ig ite peritoneutul 563 — = gre iperarteni acid de ees ‘sdevirath catastrof’ metabolicd (E. Proca) as jeedeaz, apare tabloul de ocluzie, care wane pe Be aro su ween cree nile sexual eats sel eid merece ans prs Geese ss dnb 9 eet ie ee lay re nor vara nea Se gency eres gost So ah pc zi psmoprioo He aera rapur un orn air (ol. pedi) saa prezenl de eae icece inal cinch ines eael ia Cae sess mn tunel Pr agosie Rae en ayrenan spon Spinco 92008 Saat lcd confns potted noma a Pel Bes tees prio . Sonera aot meee a ark, ln incepta captluli, afc In Cece ee singe emu cra set Se Selatcles ccnrpet cnn med cco Nae mescet a smpomisog ce maxon schon ae Newnan, bdooenl ste arava {0 Feel eine soe wert eae dere So Feet au thpoesine wel Insc ack singel Based ee pong toss Fare ocr deen aa soup areca ae homenul acut chirurgie tcbuie feu cu cel fstab ssutoate sinroameledurerasesbdominae, rizelegastie tbetiee, pur nl come diabetic, nfrtle mezentcrie,unelelziun vertebrae ndlarai al seroaseiperitoneale evolu Tndelungst cu etiologie va aspects anaomo-clncepalimore. Dud etologia lor, exist peitonite i neuberulease Pete nb taboli exe destl de mare, pari presopunind existe prealabil ubercloaseinorpnsm, Peritonitatuberuloahapae,cudeoseire, dhipersensbilitate din evoluatuberculoze.Seroas este isiminjad Fn perioda primar de goneaizar imfo-hertogen tuberSo4_Medicnginerad pentru cadre medit ln aoe tac) a poppin pin on (Golde meraie gis, sna, pepo, sont) Pee ‘Seco pe salah nal pe propel pone fo ‘nonresponse sepals bse) Behe a oes eet apr le dle sal nor ‘isnt nen xh Ino prone baie nate ss ‘sition ee malinee mts al tron napa Sco ol pacino de pte vinings he in i pete bet x ey fence an, Sl ‘inure tao: frm mae ssck ok ‘Sram ma ice Intouch prone ecogetont cu pal tease sin cri plc x sins pn fa sos Sleeve uc ma Se caman unset fis enh, ‘en gn ni mecca lh sce sy sce inte po faint, Inoe tiassSea esa ‘etc ev ut len fr veces ae peor Fetacemin comes ere ocak reason tcl snes pen alae wat ap se cli er Gem buee, ) de oom auc te ‘wleero-cazeoass,fibroadeziva) side localizare(generalizat ocalizatd). ‘ Pon nti ac Pea lel ek li le polarons paola Fem pel a seal sen ‘Geta w mei, tim, eee van Pace es ‘nde mia its mara aoa eee ao tote spect unl homens sme ae we ad ne es ‘toe inp tered cto dn ma pine ne pe sal pr pe ompetace Frclores ne Serr ete lars peribepaticualeaens gens- Bolile peritoneutut_ S65 [penta ebercsoas conc, Petes inbrace diet spect: asic Mie-cneos 224 Secs, eee a tl ince, debut nis cu fbr woarh Tape ie, run via cost, dares apt 2-338 eral ert de ci cre devine snd abdomen Hi ihidal est vn cauat sero, Dogan ince Tr cat ae aap alee, mnie pn Me impregnate esa, duct dominate continue, oi, meteor Site apa ls dcomprinarea brash : Spuma fbrcasceasd su lconvcaoar sare maids 1a aul $e pager Fae prodromal ee sa descent penne de impregnareoberet- Fen sre pecs tert pores. obra ener, pile pai, Mirch lois par arr pacmbiene, compte dare, dbdomenul se Wee rete abdoratcseacrtars Lane abdomen exs200e de Totty zos de matic ("ul ep) se pulpech imp, format Sonal neomogee (x0. Moma aed (Roeder plas ote descr send uein dz fr tcl rs rr sare le xc an Sane’ irc npn redness, conspae fomee sbocie fehl Compile ror provoncl dare dtp eva Absorenl™ {Se eva talon, ips cy ease eat sn i Bolu peroneal pognosicl et al pein ravi Aescmmcutn recut Dron relator scoicorpih manifest nce vn a eon, Jase ese Scud vndearen ve obfine Sprig ote cane NDieposied pss zoe pe senate de ipresae thers, pe tle generale pe sinptonstlgin abdominal. Anecedete personae acre xn at ocibacre pid iagosica cil Koch pon str emede clr su pin noel a iagaostcs tad elfen in forte sce ofc pin lint cauzsor Fairies doh» sbloner arin cist ovree et) $a ine doer (ror, mucafeardace,vomboce poral). ern operas et cea ce ubercleza Tn genera oles untae brelqlortatanenl romp a ole ane Fvicinea BCG nigurn unr condi bane e ah, de oe, de uray et igeic, ttc, medicaments, cu agen fz »repunal l pat se recomand pn a reabsorin acti nto cursal evolve: stare general era fbr, VS, crest, Actvitaten progres in inp vung; camera va fats permanent; cra ete indica.‘$66 _Medicintimterad pentru endre medi Dieta faze aa (bra) const in limentae wjoart eo, wn reg ‘bine echt calorie (3 500 ca), bogat in protine. Tratament elo prevede chimotrapia i antibioeepa tubercle ‘& Steplomicin, loiazida (HLLN) si PAS sant madcamente de baz. Ss 1 ‘ach 2 3 tubeculosatie. In azide reise Ia aes trata se roy fos ate beruosatice:Rifampcin, Tebemicin, Fn, Nitin (Arnac, ‘ionic, Toca Ebel 4 ‘ratamentl paiogent se ealzesk prin dinitares cotizoniclr in doce ‘ft: enon 400ml sid popes pita S20 zee mes re exudates up esrb ap Totamentul simptomatic adjuvant se fe oa amalgcie, ates, sven cz de consipai patsarent ca ere, vitaminele C.D, c lex B, cals, anabolizant: Napoin, Cleestosteroa (Strano) Mail Neel Foard ua elie pon lune Soe Can chi cmp slactiotergpa loa abo ‘utonen chil we inte de ncesinten formel cores 9. BOLILE APARATULUI URINAR Majin’ de extone erin et liu inci dosing din cil vacate ale ee, Yea urn ra. Richi orale seesoae le forma de babs de fale sant situa deo prey de alta a coloanel errno de un st cellos velit de caps illest laren Rin oman exe convex tr conv dol aul sper infer paren const il oa lett din arr yom revl, fatiele, evi jonetunen i, Richi pt ee ceva ma jonni et cel tng. Loja ima ins dei, uted ele dooney dedeubal i aponeorlelonbur ried see abdominal, Sitarea nalbarinhslscxped dec uci eae pot resi lamba au plan, devs tenererele seater mast boil eprint cu evoiesopencardmbactsimptomatologe Wins atric flog a chee nfo, lett dla {pala scl wner pl rina), Nema efor din et Beevalual a mca Cloned pul eect al oui - lnran ghem de suplt cae eu in rise wel aera oven disarccal Ciplaslesc unex oa meh outer areca ios repo tbl Ta Saldas loreal nas pressor una aa fg imurniowsie sper’ cpa Bowman tbl cow Prox, tubal contr dis tbi cleo. Copsle Bowman are foma uel Hnconjr glomeribl yee acu in dou oe. Casula Bown, jae lp car coin aut auc deol Malight Di ina prin can colcoe cea comune eres eschid a rin frat ovine de sein brnct eg arntloe erga dota vl pci sa pein apa oe ela pn cle duke. Tec abortne-pelvian a cxplicl pois compres aceon de ce Roane, chs ance retsigmonee Ut -camfl excreta veh -ae a Tene sour spe escheat, cae tact seg sade unde oso le dee un adeno, pons usc spall arbor na te file Ce ints rt ea eS‘_Medicing ntrnd pentru cadre medi (care) orgniamla de sbsiane toric, Fomarea urns datoreas ‘Sscaism comple de filae la nivel glomerulilor de eso ser ‘el bile Pi laren ghmerlr se omen rina primi (150 | rt dors din res 1501p). ria emi tl hrs {re composiia lism, dar fd protein, pide element fguate, Comin os Ts faeatrmitoare, lanl) ‘ot mbar prog,liminarea lr rna cts imedat e pain snc “Apacs eben propor de 9%, ghcnzin inrepme (condita ese can ‘ges existe mai putin de 1,60 g lucoca sure in priclar chorus x ‘odin propor vrinbia (98-99%) Substance oxic my St eabsorbite si im popoie mult mai mica (3% ure, 759 seid uc). [naira proces ds reasoieriihilarpropietip ert pu imine ert Scan ca amanincl curl tempor inch acid bare, De poe 4e forme wn cupinde ofc glomeralard, In cae pin Hisar se formes ‘ina nil (primit)9 fa abulr, eae pa Fear i accei = ‘ormeazd uri defintvt. Crcteal de rn efit ent ond doh itl nproosl de cones subialena homens erhipofza Ducati ‘Seaphpe cao arin dpe, rich lind uel substan int cntic ‘ma mare mai mic dap realtnd owhnde densa arabia forts permanent -disea(I,5-2,3 imine depo in vee oa, de uns nd se acumoeaet¢ anal eantiat (250 - 300 mi), se decangac rfl ‘micianen-deschierea finer versa ole vest Mian este st ‘ont deschdrelnhideea ince eal ptdfcomandat oan In afar de func excreta formar eliminated urn), Hach are un rl _preomimut a senineea chibi ado zi prn tminaren de cig rae ‘ean enfin plea. Rink nl sigur cons presence wrinar 569 {itr sap care poe su proce eran enue Oboe etna ily urd tverzcart adres ite bol renal Seu! Merete ct omer pot enn hr gave eran ales iaclessnsoce(nioeu, mec su mediate al pein in ncn ns ie peo a Pees rcton cx prechicre aati renin abonelrne ave. Gr Pee reac inf unre supose char dace a sparta "epee Beer ole ator yarn sa ran au eer un rset real De exempt certian ipsncnsines acral eons inerseaah teen Mit Acree pos scr ei ita rene avers Melts rls arclnal incre olinciopatotioreaebilneale MBit srepocecih sco acsve sper inten de oo at de ce (Bepente steer ert sgn gomiglr, unload dene, Hees sir crc mara nse tor sig IBpppeste ror tl pve deo supa (gomerontia rat). 122. Snpons hacia “ema ecaaesinptan aon porfcate apt ea su ea tte cere aerrltn ests wn pir mana Brees (0 reise bar opr ota, cusedil eral sn celine 0, ot radierea dureitn colle neta (an olen hepatica (b) (dupa Bony)yy ‘570 Medico internk pentru cadre medi ‘acd dre ich spe partes anterior abomenul, unin’ rc rar spel eal etre cops inemlrepetv sr ‘ai ml te ‘Durer lobe spt nitride intensitate reds (su), sy exo por eal ie eal latent, ilonefPi,oherculors su sac ral Dare lobar bse ou caster sd a de afin prea gon ruloneiel soe frie in slrozele renal ee. "Clad dare singe o mare intensiae exe unter 9 aprein exis ps nice cin debuts in regies lobar adi pe trail wreterl ope fou ine. repines ghia orale gentle fia inte a coupe especie pear denies de cold renal sau nf. Dureea ete atoce, prmanc'. ‘Shimer parxice are caracter de sfigcre, aut lpr sa rie Bolsval ese agi nud - fins reujeasel ~ 0 pie deur at se) imperonse de icine, dar mu eee wineze dec eleva pest de ui ‘recta comnid aesea singe. Dureres ponte dfn qn egies lon ‘opt nip clic por apiea ale ere rn (pola, lige, este veil) au tbr gastrointestinal reflex (rear, visitun, sto, Consipae).Uneor,colca ape fo cuzh anime acon este provost cc ‘denen, abu alimentar et. Poute precede duet lobar vs. ‘sw lamijive su hematuria de obi apr bial poem cen esa ale. Apare in Ua renal (clad eate pre in rete), ma a dronefioz, in eanceal sau uberculora eal. Tbr i emisunea wit paki, due tre, ree de wri 3 incomineni Prin polar eIfelegeeryerea coven tui, a tre dieulata sau deen la mine Ace tbr par de bie im rein. Labia, deo pete 6 de ani, pi cue caretebule ere ‘te adeoomul de pros. Cis ete ns cea al fecvent cau. Tubercle ‘te, de asemenes, deseo o cuz a iti afl iste uretle ‘Nira dseeneat staan care bola exe ligt se soa oat ein rina Noman impu som a spare necestates de arin Nits te scandal cae prowoed sua, polar polini dracon ‘steam em de insficient carat sau slr renal. ‘etena de wrind-adchinpoibiinte boar de gai ‘ommletl nce cz se podace dasa ei, care ponte ge I cb, ‘ombindinhipogsra (lo yeica Retna cd bln dy rinse, si poate gi complet cfm veel, ere ae poate infect ap Rete durin apare nto sle posal calla tur real ele ‘ezun alesse ners, bes, Bemoragie cerebral plz genera ‘omatune ee acontnen de arind ete emi avon de wind. Apr ‘speci aco. aul poste ape In ein al ves wiare ale sisters ‘servos cena sa ale idol spin, 2 eee ee erin poate Botte sparatalul urinar S71 penance pce es eee oe cc a ee ea oe oes ctr ere Mean diene pr use conconrae er.lguia inser eee Eerie one ee ee ee ee ee oe — ee Geiloarerogie-deschist sau inchiss. Numa hematuria macroscopicd este un simptom a ee oe a ee oe a ocean eset a aa By y i‘572 Mii itera pentru cadre medi ‘oul. Hematuia poate fi decide natu renal (ita, tberculord, ean ‘slomealnefie), veal (iar, tuned, beret, rosa (adenom, cn ‘real (areris,eaumatsme sau general ndroare hemoragice cc} ‘Piura adc pez prvi nw se wade macroscopic eintan spect uur uno, aru pote frat dect prin examen nites, ‘are evienicl prezejauner esos plileare mi mls nai pun sc Pruriesttodeauna dtr une lexan spar rina, Siac se poms coe ‘apo clr el pasre pen a presin origins pire, 933, Somme fice ‘Examen obcctv al apart rina se fic in ordinea casi. _Inpecta general fers iemporants date agnostic, De exemple, ozs “in coy de pel” (in decubt Intel depart Dolnav) este luk de olan ce ‘lett penta ogres drei Pale tegumentelor senate a bolas insti roa conc (aremi) Dar seal cel ma imprint xe edem, ‘are ade ohieridratae excell, Uncoi ete discret (declan ‘cera blnaulin great) sie cesieabilanendd inflata est

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Saati Saat ertial eon, nefropa tubule;