Patologie Medicala Sem 1

7/25/2019 Patologie Medicala Sem 1

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1. STOMATITELE. ETIOPATOGENEZA, SIMPTOMATOLOGIE, DIAGNOSTIC SI TRATAMENTdefnitie

- aectiune inaat!"ie #a ni$e#u# uc!a%ei &uca#e %i in ca'u"i ("a$e %i a te%utu"i#!"

%u&adiacente "e'u#tand c)ei#ita *inaatia &u'e#!"+, (#!%ita, e"i%t!atita

*tueactia %i e"utia de #a ni$e#u# &u'e#!" %i c!i%u"i#!"+eti!at!(ene'a

- cau'e "ia"e ania#e "edi%u%e, i"itatii c)iice, ecanice, a#e"(ice- cau'e %ecunda"e &!#i denta"e, (a%t"!ente"ice, ne"ite c"!nice a'!teice- %it!atice in e&"a at!a%a, nec"!&aci#!'a, actin!&aci#!'a, candid!'a,

t"ic)!!n!'a, %t!atita #i!#a%!cita"a, u#ce" eu'in!f#ic, &!a#a uc!a%e#!"%it!at!#!(ie

- di%a(ie &uca#a a&ate"e, e&"a, %#a&i"e, de%)id"ata"e, #iadenita %u&andi&u#a"a- )ie"%a#i$atie- #e'iuni / cata"a#a, $e'icu#a"a, u%tu#!a%a, c"ua#a, dite"!ida, e(!n!a%a,

u#ce"ati$e, (an("en!a%a- (#!%ita inca"cata, u#i(in!a%a *deune"i neuni!"e %i c"e$a%e+, %a&u"a#a,

e"iteat!a%a"!f#a0ie %i t"ataent

- e#iina"ea cau'e#!", c!n!"t i(ienic %i "!f#a0ie %ecifca in ce#e %it!atice- "e(i dietetic nut"etu"i %ei#ic)ide, $e"'i, "adacin!a%e, nei"itante, aa #a di%c"etie /

u%!" &ica"&!natata.- t"ataent %tiu#ente, $itaine, euetice, antiinecti!a%e, antiic!tice- t"ataent #!ca# %a#atu"i #!ca#e cu aa &ica"&!natata, %u#at de cu"u, a%t"in(ente

%uc de #aaie, a#&a%t"u de eti#en, (#ice"ina &!"a0ata, ic!%tatice- antiinaat!a"e ne%te"!idiente / ent"u a nu %cadea "a%un%u# iun

. SIALOADENITELE- inaatia (#ande#!" %a#i$a"e di%a(ie de ti &uca# %au a"in(ian, %eud!t"i%u#,

e&"a, de!"a"ea &uca#a

- c#inic anie%ta"i#e deendete de tiu# inaatiei cata"a#e, u"u#ente,(an("en!a%e, %c#e"!a%e

- diagnostic:die"entia# ata de %t!atite %i a"in(ite *unde nu e0i%ta de!"a"i+- etiopatogeneza- cau'e "ia"e c!"u"i %t"aine- cau'e %ecunda"e dua inaatia cana#e#!", eta%ta'e- e$!#utia e%te de ti acut- tratament antiinecti!a%e e ca#e (ene"a#a *%i%teica+, d"ena"ea a&ce%e#!",

c!"e%e "eci, %!nda2e, antiinaat!a"e ne%te"!idiene, indea"ta"ea (#ande#!"

(an("enate, adini%t"a"e %e" anti(an("en!%

3. TRATAMENT4L 5ARINGITELOR- igienodietetic e$ita"ea "i(u#ui, a %c)i&a"i#!" &"u%te de tee"atu"e, a cu"enti#!"

de ae", aa %i nut"et #a tee"atu"e c!"u#ui, adini%t"a"ea de )"ana cu %!nda #a

ne$!ie- medicamentos:te"e&entina, en%u#atii cu tinctu"e de i!d, c!"e%e cu a#c!!#- en%u#atii inte"ne cu a#&a%t"u de eti#en, c#!")e0idina, (#ice"ina, ae"!%!#i- antiinecti!a%e (ene"a#e, %tiu#ente, euetice, en'6e

7. DIAGNOSTIC4L DI5ERENTIAL IN 5ARINGITE, PARALIZIA 5ARINGIANA, LARINGITA,

EMPIEM4L P4NGILOR G4T4RALE- a"in(ita di%a(ie, tu%e, 2eta2 a#ienta", a%ticatii in (!#, du"e"e #a a#atie, aetit

"edu%, %u&e&"i#itate- a"a#i'ia a"in(iana #i%e%c %ene#e inaatiei, !"(anu# e%te a%c- #a"in(ita #i%e%te 2eta2u# a#ienta"- eieu# un(i#!" (utu"a#e


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8. PARALIZIA 5ARINGIANA- %e anie%ta "in di%a(ie a"in(iana, #i%a %ene#!" de inaatie #!ca#a- e%te de "e(u#a a"a#i'ie &u#&a"a in tu"&a"e, %eud!tu"&a"e, &!tu#i%, ic!t!0ic!'e- ai "a" de natu"a e"ie"ica i!di%t"!fe, %c#e"!'a dua a"in(ite, defcit de $itaina

E %i %e#eniu- %ene c#inice di%a(ia

- diagnostic "e'e"$at %"e ("a$- tratament dietetic cu %!nda- tratament symptomatic %t"icnina, $it. &1, (#uc!nat de Ca, acuunctu"a, a%a2e

9. ESO5AGOSPASM4L. ETIOPATOGENEZA SI TRATAMENT- c!nt"actie t!nica, tetanica, inte"itenta a e%!a(u#ui cu !"i"e &"u%ca a c!n%uu#ui

de a#ieente- clinic:%ia#!"ee, e:!"t de de(#utitie in (!#, $!itu"itie %au a#%a $!a, unde

antie"i%ta#tice, %en'atie de c!"d!n du", den% %i du"e"!% #a a#atie, "e'i%tenta #a

%!nda2eti!at!(ene'a

- e%!a(!%a% "ia" #a ania#e#e i"ita&i#e, de'ec)i#i&"ate neu"!$e(etati$ %au

act!"i !ca'i!na#i nut"etu"i "ea "eci, fe"&inti, "e'idu"i indu%t"ia#e, "ica, e!tii,

ane%te'ice- e%!a(!%a% %ecunda" %au %it!atic aa"e in tetan!%, ei#e%ie, tu"&a"e,

int!0icatii cu %t"icnina, )i!$itain!'a &1, e%!a(ite, i"itatii- tratament: "eau% %i in#atu"a"ea cau'e#!"- medicamentos:t"anc)i#i'ante / 0i#a'ina, c#!"de#a'in, niediina, c!&e#en,

at"!ina;"!caina, %c!&uti#, n!-%a, aa$e"ina, n!$a%u#


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?. STENOZA ESO5AG4L4I- dia(n!%tic difci#, "!(n!%tic "e'e"$at- "e"e'inta in(u%ta"ea #uenu#ui e%!a(ian ca u"a"e a cicat"ici#!" "et"acti#e "!"ii

%au dat!"ita c!"e%iunii e0te"ne a%u"a !"(anu#ui- simptomatologie di%a(ie "ecidi$anta, e0u#'a"ea a#iente#!" dua de(#uti"a

cat!"$a &!#u"i

- ante"i!" %ten!'ei %e !ate "!duce di#atatia e%!a(u#ui- tratament:dietetic - a#iente %ei;#ic)ide- tratament:c)i"u"(ica# in tu!"i, a&ce%e, adini%t"a"e de antiinecti!a%e, i!du"ate

in inaatii

[email protected] SI DIERTIC4LE ESO5AGIENE- di#atatia e%!a(iana !ate inte"e%a #a"(i"ea ci"cu#a" "in c"e%te"ea e(a#a a tutu"!"

diaet"e#!" #uenu#ui *ecta'ie+ %au a#te!"i uc!a%a )e"nia'a e ! '!na "edu%a in

%t"uctu"a e"eti#!" !"and ! un(a *2a&!u+%it!at!#!(ie

- !&%t"uctii e%!a(iene "ecidi$ante duate cu die"ente in unctie de ("ad %i #!ca#i'a"e

"in de!"a"e %i di%nee- e#e aa" dat!"ita t!0ic!'e#!", di%aut!n!ii *di%unctii SN / ca#, caine, i%ica+,

encea#!atii- %ecunda" ia%teniei, )i!t!niei e%!a(iene, i!atii#!", %ten!'e#!", ade"ente#e!"

e%!a(iene- e(ae%!a(u# e%te cea ai !&i%nuita cau'a a "e(u"(ita"ii #a caine dat!"ita

di%unctiei neu"!u%cu#a"e find de natu"a idi!atica- diagnostic %ene c#inice %i "adi!#!(ie- tratament "atii de%e, )ie""!teice, de #a ina#tie %au c)i"u"(ica#

11.ESO5AGITELE- dete"ina di%a(ie e%!a(iana cu "e(u"(ita"ea %a#i$ei, aei %au nut"etu"i#!" e na"ine

#a ca&a#ine, e na"i %i (u"a #a "e%tu# %ecii#!", c!#ici a#%e din cau'a %a%u#uie%!a(ian

- du"e"e #a %!nda2- !"a e(!n!a%a, "ece, c"eitanta, (an("en!a%a, !%i&i#a tueactia- dia(n!%tic e0c#ude"ea a#t!"i aectiuni a#e e%!a(u#ui- e%!a(ite "ia"e i"itatii c)iice %au ecanice- e%!a(ite %ecunda"e in a#te &!#i e%!a(iene %au (a%t"ice- e%!a(ite %it!atice in (u"a, actin!&aci#!'a, T>C, e&"a at!a%a, I>R, PPC,

"u2et, )i!de"!'a, candid!'a- "!(n!%tic "e'e"$at %au ("a$ *ie"de"i ec!n!ice+- tratament dietetic a#ientatie #ic)ida %au %ei#ic)ida, a#ientatie a"ente"a#a -

3 'i#e- tratament medicamentos %a%!#itice, anti&i!tice in !"a (an("en!a%a %au

e(!n!a%a

1.>OLILE G4SII

INGLUVITAB (u%a !a#e, "ec$enta #a (aini, cu"ci %i !"u&ei, de !&icei cata"a#a %i

ai "a" %eud!e&"an!a%a

- !difca"ea %ta"ii (ene"a#e, a"i"ea in $!#u a (u%ii cu c!ntinut !a#e, $!ita"e

a#%a- "ia" nut"etu"i tai!a%e %au i"itatii c)iice- %it!atic in dite"!$a"i!#a, )!#e"a, e%ta a$ia"a, candid!'a, t"ic)!!n!'a,

)i!$itain!'e A %i >- tratament eti!#!(ic, i'!#at (!#i"ea (u%ii, a!i de -3 !"i e 'i ! #in(u"ita de C# 1,

acid #actic %au %uat de 5e

GUSA PN!ULANTAB a"i"ea e0a(e"ata a (u%ii ce endu#ea'a in !entu#

de#a%a"ii


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- aa"e #a uii de (aina %i cu"ca- eti!#!(ic candid!'a, ca"enta in >9 %au c!n%u e0a(e"at de nut"et

"#ST$U%TIA GUSIIB indi(e%tie %!"adica / a&ate"e, de(#utitie in (!#, '("i&u#i"e,

a"i"ea (u%ii, t!'a, c!ntinut a%t!% %au du"

- )i!t!nia (u%ii dat!"ita c!n%uu#ui unei cantitati a"i de %einte u%cate, #ea$a,

ta"ate, c!"i %t"aini, ca"ti#a(ii, tend!ane, #a"$e

- %e in!aie c!ntinutu# %i a!i %e incea"ca (!#i"ea (u%ii

13.PAREZIA PRESTOMACELOR

- %e"e'inta %cade"ea %au %u%enda"ea t!nu%u#ui u%cu#atu"ii c!a"tiente#!"(a%t"ice ca"e dete"ina ! a(#!e"a"e e0a(e"ata de a#iente in ace%te $i%ce"e %i !inta"'ie"e in e$acua#"ea #!".

- %e ca"acte"i'ea'a c#inic "in a&ate"e, di%!"e0ie, "educe"ea "ue(a"ii %i deeca"ii "in"educe"ea i%ca"i#!" e"i%ta#tice %i di%t!nie "e%t!aca#a.

- aa"e di%ic"!&i% %i indi(e%tie &i!c)iica * %i#a, a#ca#ina %au ut"ida +, e$entua#ete!"i% ia" in !"e#e de du"ata %#a&i"e %i aneie.

- aa"e ca u"a"e a &!#i#!" "e%t!aca#e %i e"it!nea#e, a#e c)ea(u#ui %i ai "a"dat!"ita %t"e%u#ui, un!" int!0icatii, inectii i!%eticeice, a#e &!#i#!" nut"iti!na#e.

!iagnostic& volutie& Prognostic& Pro'la(ie&

- dia(!n!%tic %it!atic u%!" de u%.- e$!#utia %i "!(n!%ticu# deinde de &!a#a cau'at!a"e, a"e'ia find de "e(u#a

%ecunda"a.- "!f#a0ia $i'ea'a ai u#te %ta"i at!#!(ice, a#ientatia, de(#uti"ea c!"i#!" %t"aini,

%t"e%.

Tratament

- e%te ce# a# &!#ii "ia"e- "educe"ea a"e'ei %u"ia"ea u"a2a"ii ti de -3 'i#e, int"!duce"ea t"etata a

u"a2e#!" u%!" e"ente%ci&i#e- %tiu#a"ea !ti#itatii "e%t!ace#!"-#i&a"e, a%a2, adini%t"a"e de eetice,

%t"icnina, %u#at de a(ne'iu, et!c#!"aid, Rui%an, Ruin!di(e%t, tinctu"iaa"e.

- "ein%aanta"ea "uenu#ui, $a(!ietice- t"ataent edicaent!% in ca' de indi(e%tii, ete!"i%.5!a"te uti# dete"ina"ea -u#ui "uina#, a# #ate#ui, a# u"inei

17.RETIC4LITA SI RETIC4LOPERITONITA TRA4MATICA

- %unt inaatii a#e "ete#ei %i;%au e"it!neu#ui deteinate de i("a"ea c!"i#!" %t"ainieta#ici de #a ni$e#u# "ete#ei.

- "!duc ie"de"i di"ecte "in %ac"ifca"ea ania#e#!" %i indi"ecte "in %cade"ea"!ductii#!", c!nf%ca"ii de !"(ane %au ca"ca%e.

- t"aue#e #!ca#e "!duc du"e"e %i a"e'ie e ca#e "ee0a, ia" "!ce%u# inaat!"dete"ina indi(e%tii t"auatice.

- a%u"a %ta"ii (ene"a#e "!duc e&"a, tu#&u"a"i nut"iti!na#e %i en!ene t!0ice.- c!#icatii "ec$ente e"ica"dica dia"a(atica, )eatita "in i("atia %i

in%aanta"ea &acte"iana de cat"e c!"ii %t"aini %i ai "a" e ca#e eta%tatica.tiopatogeneza- "edi%!'itia $aci#!" in $a"%ta de -= ani, cu "!ductie a"e, cu %ind"! de ica.

- c!"ii %t"aini din "etea "!duc e"!"a"ea ace%teia %i cu !%i&i#itatea i("a"ii c!"i#!"#a di%tanta, i("a"ea e%te aci#itata de cat"e (e%tatie, at, t"an%!"t, ete!"i%,%u"ainca"ca"ea "uenu#ui, u"(ati$e, di#atatii %i )ie"t"!fi ca"diace.

Simptome- Reticu#ita acuta %i#a- %cade"ea &"u%ca a c!n%uu#ui de nut"et


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- %cade"ea "!ductiei de #ate- a"e'ia "e%t!aca#aSimptome- Reticu#it!e"it!nita acuta #!ca#i'ata- ci!'a, acie% %e"iat, (eete, c!#ici, du"e"e, c!n%tiatie- Sunet tiatic int"e 0i!id %i !&i#ic- Lic)id %e"!% %au u"u#ent #a unctia a&d!ina#a

Simptome- Reticu#!e"it!nita acuta diu'a- accentua"ea %ene#!" c#inice ante"i!a"e cu a"a#i'ia c!#eta a "uenu#ui, tu#&u"a"ici"cu#at!"ii, dete"i!a"ea %ta"ii (ene"a#e, %!c !a"te in 1- 'i#e

Simptome -Reticu#ita c"!nica- a%it!atic- a"e'ia "e%t!aca#a- Sind"! !undSimptome - "eticu#it!e"it!nita c"!nica- %#a&i"e, "educe"ea #actatiei, ete!"i% c"!nic, Sind"! !und, cet!'a!iagnostic: %cade"ea &"u%ca a "!ductiei de #ate, du"e"e %!ntana "e%t!aca#a,"eactie #euc!cita"a) detecta"ea eta#e#!"

Pro'la(ie: &a#!ta"ea cu %!a"a, c!#ecta"ea eta#e#!") #a%a"ea de a(neti in "etea

Tratament: dec#in!te"aie -3 %ataani, %u%enda"ea a#ientatiei -3 'i#e,adini%t"a"ea de u"a2e %ei#ic)ide %i an de &una ca#itate, adini%t"a"eaint"ae"it!nea#a de anti&i!tice %au %u#aide, "e)id"ata"e, (#uc!'a, ca#ciu, $itaine, inneu!e"it!neu / inte"$entie c)i"u"(ica#a.

18.GEOSEDIMENTOZA- %e anie%ta "in %ene de indi(e%tie "e%t!aca#a di%aetenta, %a#i$atie, a"e'ie,

ete!"i% "ecidi$ant, dia"ee u%!a"a, %it!e de "uinita, ni%i %au aant ineca#e

- %it!e %#a&i"e, de%)id"ata"e, dia"ee cu ni%i %i aant in eca#e, du"e"e,c"eitatie

- dia(n!%tic indi(e%tie "e#un(ita, "ecidi$anta, "e'enta de aant;ni%i in eca#e- de!'it aant!% in c)ea( / ana #a 18F( %i cantitati c)ia" ai a"i in "uen- %unt "edi%u%e $aci#e cu dete"i!"a"ea t"an'itu#ui di(e%ti$ &at"ane, "!ductii

c"e%cute, in %ta&u#atie, cu &!#i di(e%ti$e !da#e, cantitati a"i de aant in nut"et- e$!#utie t"enanta, cu dete"i!"a"ea "!("e%i$a a %ta"ii ania#u#ui- t"ataent in#atu"a"ea cau'e#!", a"afna #ic)ida, u"(ati$e %a#ine in uci#a(,

i#!ca"ina- #a ne$!ie "ui!n! %i a&!a%!t!ie cu in#atu"a"ea anua#a a de!'itu#ui te"!%.- "e)id"atante %i %tiu#ente, t"ataent ent"u "uinita %i a&!a%ita.

19.R4MINORETIC4LITE NETRA4MATICE

Semne cliniceSe anie%ta "in c!#ici, a"e'ia "e%t!ace#!", du"e"e #!ca#a, $!ita"i, dia"ee,de%)id"ata"eIn in("a%at!"ii aa" !"e atiice, "educe"ea %!"u#ui i#nic, %#a&i"ea "!("e%i$aLe'iuni de ti cata"a#, e"!'i$, )ie"Fe"at!'ic f&"!% %au ("anu#!at!%

tiopatogeneza- RRN "ia"e /deind de i"itatii ecanice * nut"etu"i, aant, c!"i %t"aini + %au "in

c)iica#e- RRN %ecunda"e /%unt c!n%ecuti$e indi(e%tii#!" &i!c)iice- RRN %it!atice /aa" in $i"!'e e"uti$e, T>C, actin!&aci#!'a, ic!'e, a"a'it!'e- Le'iuni#e "uin!"eticu#a"e e c!#ica cu inectii %u"au%e ca"e !t (ene"a eta%ta'e

!iagnostic a"e'ie "e%t!aca#a, du"e"ePrognostic ec!n!ic-"e'e"$atPro'la(ie in "incia# nut"iti!na#a %i inecti!a%aTratamentRe%t"ictii u"a2e"e ti de cate$a 'i#e


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Int"!duce"e t"etata a u"a2e#!"Cantitati "edu%e, %t"!tu"i dec!ctu"i, uci#a(ii, an de &una ca#itate, nut"et $e"deMedicaent!% an%aente * !"e', in + %i a%t"in(ente, %!#utii e#ect"!#itice, anti)i%tainice,antiinecti!a%e in ca'u"i ("a$e.Ce#e ai i!"tante u"(ati$e %a#i(ne

1


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Di#atatie e0a(e"ata, &"u%ca a "ete#ei %i a "uenu#ui "in acuu#a"e de (a'e de e"entatie%au "in acuu#a"ea de %ua !"ata din $e'icu#e fne ca"e %e %a"( %i ca"e %e ae%tecadiu' in c!ntinutu# "uena#.

1?.METEORISM4L R4MINAL AC4T ETIOPATOGENEZA

C!n%u de nut"etu"i tian!(ene #uce"na, t"i!iP"!duce"ea de di%ic"!&i%, "educe"ea %a#i$atiei, c"e%te"ea %u!'itati#!", "educe"ea%tiu#a"ii "e#e0e#!" ca"dia#e.Reduce"ea e"uctatiei, acuu#a"ea de (a'e %au %ua in "uenO&%t"uctii#e e%!a(iene, "eticu#!!a%a#e, i#!"ice dete"ina "educe"ea e"uctatiei %iacuu#a"ea de (a'ePa"e'ia "e%t!aca#a dat!"ata &!#i#!" "e%t!aca#e, e"it!nea#e, (ene"a#e, $a(!#itice /"educe"ea e"uctatiei %i ete!"i%.

@.METEORISM4L R4MINAL AC4T DIAGNOSTIC SI TRATAMENT

- dec#in!te"aie t a$!"i'a"ea e"uctatiei, a%a2 "uina#, a%e"%iuni cu aa "ece,

#a%a"ea unui ca#u% in (u"a, %a%!#itice, %!nda2- !#ie"i %intetici !#!0a#ene @(;ca;'i- adini%t"a"ea de antie"ente%ci&i#e aa de $a", u#ei a"%, acid c#!")id"ic- u"(ati$e %a#ine, &en'!at de %!diu, %i#ic!ni, !"!#, et"!#- anti&i!tice- "uin!t!ie- %u%enda"ea a#ientatiei

1.METEORISM4L R4MINAL AC4T SIMPTOMATOLOGIE

- Di%ten%ia e0a(e"ata a "uenu#ui, di%nee ("a$a cu tendinta de a%f0ie %au %!c.- Indi(e%tie (a'!a%a %au %u!a%a.- Reduce"ea ana #a a&!#i"ea e"uctatiei %i "ue(a"ii.- Reduce"ea deeca"ii.- E$!#utie de cate$a 'eci de inute %au !"e.- Pie"de"i "in %ac"ifca"e %au !a"tea ania#u#ui

.METEORISM4L R4MINAL CRONIC ETIOPATOGENEZA SI TRATAMENT- %ind"! ca"e e0"ia acuu#a"ea inte"itenta de (a'e in "uen- initia# ete!"i%u# aa"e #a inte"$a#e a"i de ti dua ca"e din ce in ce ai

"ec$ent- ("adu# de e0"ia"e ai "edu% decat in ete!"i%u# acut- e"uctatii etide, i%ca"i "uina#e ai %#a&e %i ai "a"e, aetit ca"ici!%, %#a&i"e, ica,

"ue(a"e #ene%a, ade%ea int"e"uta- t"ataent i!du"ate %i antiinecti!a%e in c!#ectii#e actin&aci#a"e a#e #i!n!du#i#!"

edia%tina#i- nut"etu"i de &una ca#itate, tainu"i ici, "uinati$e, ca"&une, u"(ati$e %a#ine in d!'e

ici- in e"i!ada de inta"ca"e in!eta"e, a#ientatie dietetica %i ca"&une edicina#,

ca"&!nat de ca#ciu, anti&i!tice %i in%aanta"ea "uenu#ui- %i!na2 "uina#

3.INDIGESTIA AGALA SIMPTOME SI TRATAMENT- aectiune neu"!#!(ica / c!"e%iune e ne"$u# $a(- c#inic %tan2eni"ea a%a2u#ui a%ei a#ienta"e dint"e "etea %i !i!% c!n%ecuti$a

a"e'iei unei %au ai u#t!" "au"i a#e $a(u#ui- "e'u#tatu# e%te di#ata"ea ante("ada t"etata a "e%tace#!" a#atu"i de tiani%

!de"at, "ecidi$ant- di%ten%ia a&d!enu#ui e%te a%iet"ica / in !"a de LH


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- in %ten!'a i#!"ica e"anenta de%)id"ata"e, a#ca#!'a eta&!#ica, c!nt"actii"uina#e "e'ente da" diinuat, di#atatie

- t"ataent inte"$entia c)i"u"(ica#a ent"u in#atu"a"ea a&ce%e#!", ade"ente#!"- anti&i!te"aie ent"u "eticu#!e"it!nite- t!nife"e, "e)id"ata"e, et!c#!"aid

7.O>STR4CTIA *PAREZIA+ 5OIOS4L4I-- cau'e "ia"e dua c!n%u de u"a2e &!(ate in #i(nina, f&"e taiate %cu"t, u%cate- %ecunda" in &!#i di(e%ti$e %au e"it!nea#e- %it!atice inectii, &!tu#i%, int!0icatia cu P&- %ene c#inice in !"a %i#a, %ene di%c"ete de indi(e%tie, c!#ici, c!n%tiatie,

eca#e in cantitate "edu%a %i (#e"!a%e, %u"ainca"ca"e %i ete!"i% "uina# "edu%- dia(n!%tic nece%ita ade%ea #aa"at!ie- e$!#utie c#inica ana #a ! %ataana, cu $indeca"i %!ntate %au %!c !&%t"ucti$- t"ataent adaa"e #a di%c"etie, #a ne$!ie cu %!nda, 'i#nic -3 'i#e 1-# de a"afna

%au u"(ati$e %a#ine 18@-3@@# in =-1@ #it"i uci#a(iu- c)i"u"(ica# / $ida"e anua#a / "uin!t!ie

- "e)id"ata"e a"ente"a#a, $it, %a"u"i de Ca, (#uc!c!"tic!i'i

8.INDIGESTIA R4MINALA >IOCIMICA SIMPLA

E$!#ue'a initia# %u&c#inic cu e$identie"ea d!a" #a c!nt"!#u# de #a&!"at!"A!i %ene neca"acte"i%tice %cade"ea "!ductiei de #ate %i a ("a%iii din #ate, aetitca"ici!%, a"e'ia "e%t!aca#a, ete!"i% "uina# "ecidi$ant.S#a&i"e, aneie, inta"'ie"ea in c"e%te"eCet!'a %u&c#inica, in%ufcienta )eatica, !%te!enie, )i!a$itain!'a

Tu#&u"a"i de "e"!ductie

!iagnosticSe !"ientea'a e ideea aa"itiei un!" "!ee "i$it!a"e #a %anatatea eecti$u#uiScade"ea "andaentu#ui "!ducti$ %i "e"!ducti$E$!#utia e%te t"enantaP"!(n!%ticu# ec!n!ic e%te ("a$P"!f#a0ia %e "ee"a #a ec)i#i&"a"ea "atiei, i(iena u"a2a"ii

TratamentO t"ece"e "etata #a "atie ec)i#i&"ata cantitati$ %i ca#itati$Su!"t "!teic %i ene"(etic-'a)a"u"i u%!" di(e%ti&i#e "in %ec#a %au e#a%a,ine"!#a$itainicRuinati$e

D"!2die &e"eRein%aanta"ea "uenu#ui

9.INDIGESTIA R4MINALA ALCALINA DIAGNOSTIC SI TRATAMENT

!iagnosticIndi(e%tieRatie de'ec)i#i&"ata ene"(!;a'!tata in a$!a"ea a'!tu#uiInt"!duce"ea &"u%ca in c!n%u a unei a%te# de "atie-u# "uina# c"e%cute$!#utia e%te %u&acuta, t"enanata %i %e !ate c!#ica cu indi(e%tie ut"ida %au cu!"a acuta

P"!(n!%tic "e'e"$at %"e ("a$.

TratamentDietetic-%u"ia"ea %u&%t"atu"i#!" &!(ate in a'!tAdini%t"a"ea anu#ui de cea ai &una ca#itate


9/25

Su#ienta"ea de )id"!ca"&u"i c!ncent"ate, &!(ate in aid!n, %ec#a de 'a)a", e#a%a%au c)ia" 'a)a"Medicaent!%-ta!na"ea e0ce%u#ui a!niaca# din "uen cu 8@@ # de !tet %au 8@-OLICA LATENTA ALIMENTARA ETIOPATOGENEZA SI SIMPTOME

tiopatogeneza si simptomeI!"tanta d!a" #a "ue(at!a"e %i ca"acte"i'ata "in anie%ta"i nut"iti!na#eE%te e0"e%ia defciente#!" a#ienta"e #a ca"e %e !ate a%!cia "edi%!'itii #adeendenta de die"ite !"(an!atii.AMLA de !"din a#ienta" "e%uunand de'ec)i#i&"e de "atie %i a#te defciente de i(ienaa#ienta"a, in a%u"a %a de'ec)i#i&"e'e aciditatea "uina#a * e0ce% de acid "!i!nic%au &uti"ic, defcit de acetat (ene"and %cade"ea ("a%iii din #ate +, at !%i&i# in t!ateindi(e%tii#e &i!c)iice "uina#e de ("a$itate "edu%a, in "incia# de tiu# indi(e%tiei

%i#e %au a# c!#e0u#ui "uinita a&ce% )eaticAMLA "in in%ufcienta !"(ane#!" de "e(#a"e acid!&a'ic ca in in%ufcienta )eatica,ne"!atii, neu!atii c"!nice.AMLA "in e0ce% de aci'i eta&!#ici ti%u#a"i, ca in e&"e "e#un(ite, ti"et!0ic!'a c"!nica,%t"e% c"!nic, %u&a#ientatie %i cet!'a #etenta.


10/25

Ade%ea eti!at!(ene'a e%te i0ta cu i#ica"ea ai u#t!" ecani%e da" in t!ateca'u"i#e c!n%ecinta fna#a find defcitu# de %c)i&u"i nut"iti!na#e #a ni$e#u# "incia#e#!"!"(ane %i te%utu"i acid!'a #atenta.Semne cliniceManie%ta"i#e atiice in %ecia# tu#&u"a"i de "e"!ductie, de "!ducti$itate %i "eacti$itate(ene"a#a, cu %unt %cade"ea #actatiei %ia ("a%iii din #ate

Scade"ea c"e%te"ii, de'$!!#ta"ii, in("a%a"iiA%tenie, aneie, !%te!enie, #ainita, c"e%te"ea incidentei "etentii#!" #acenta"e, aet"ite#!", a aite#!"

!iagnosticDe %u%iciune defciente de u"a2a"eC!nf"a"e "in e0aene de #a&!"at!" %cade"ea -u#ui #ate#ui *

3.COLICILE TRATAMENT- t"ataent #i&a"e #a a% ent"u e$ita"ea t"anti"i#!", &u%ua"i "eetate e

a&d!en, %!nda2u# (a%t"ic- ca#a"ea du"e"i#!" "!caina , at"!ina, a#(!ca#in, c!&e#en, "!un

- ecacua"ea t"actu%u#ui (i e %!nda na'!-e%!a(iana %au "ecta#- "e)id"ata"ea %i "e%a#ini'a"ea %!#utii de e#ect"!#iti- c!&ate"ea acid!'ei 8@( &ica"&!nat de %!diu int"-un #it"u aa di%ti#ata %te"i#a- c!&ate"ea %!cu#ui adini%t"a"ea de (#uc!'a, $it. C, $it. >


11/25

33.DISPEPSII SECRETORII GASTRICE- eti!at!(ene'a defciente de i(iena, inte"$entii a#e a("e%!"i#!", ne"e(u#a"itati

denta"e, di%unctii %ec"et!"ii *de C# / cu e"tu"&a"ea di(e%tiei %i nut"itiei+, di%unctii)ie"c#!")id"ice B (a%t"ita, u#ce" (a%t"ic %au du!dena#

- %ene c#inice %#a&i"e, dia"ee, !difca"ea eca#e#!"- di%e%ia )ie")id"ica c!#ici u%!a"e, c!n%tiatii, !#idi%ie, %a#i$atie

- di%e%ia )i!)id"ica a%tenie, dia"ee, &!"&!"i%e e0a(e"ate, uc!a%e u%cate,"e%tu"i nedi(e"ate in eca#e- dia(n!%tic e &a'a %ene#!" c#inice / !difca"i at!#!(ice deendente de &!a#a

"ia"a, %au de c!#icatii !"(anice- "!(n!%tic a$!"a&i#- t"ataent eti!#!(ic a# &!#ii "ia"e, dietetic nut"etu"i de &una ca#itate, tainu"i ici

%i de%e- t"ataent edicaent!% in !"a )ie"c#!")id"ica B adini%t"a"ea de &ica"&!nat

de %!diu, an%aente di(e%ti$e )i%tainice *"anitidina+- !"a )i!c#!")id"ica %tiuu#a"ea %ec"etiei de C# "in %u#ienta"ea "atiei cu %a"e

de &ucata"ie, e%ina, c!#e0 >

37.GASTROPATIA 4LCEROASA SIMPTOME, DIAGNOSTIC SI TRATAMENT- aa"e #a %uine, a%a"i, $itei, &e"&ecuti- e$!#uea'a a%it!atic %cade "!ducti$itatea, aneie, %a#i$atie, de(#utitie in (!#,

&"u0i%, dia"ee;c!n%tiatie, c!#ici, a"e'ii, ete!"i%- !"a %u&acuta a%tenie, %#a&i"e, aneie, c!#ici, $!a, )eatee'a %au e#ena- !"a %u"aacuta )e!"a(ie inte"na- dia(n!%tic %ene c#inice, e0aen c!"!, )eat!#!(ic, d!'a"e e%in!(en,

ec!("afe, end!%c!ie, "0 cu %u&%tante de c!nt"a%t- t"ataent i(ien!dietetic, an%aent (a%t"ic, "anitidina, )e!%tatice, antianeice,

inte"$entie c)i"u"(ica#a

38.DILATATIA AC4TA A STOMAC4L4I. DIAGNOSTIC SI TRATAMENT- %!nda2, e0 ec!("afc, (a%t"!t!ie e"ie"ica- %ene c#inice ca&a#ine c!#ici ("a$e, a&d!en in &ut!i, 2ena "e%i"at!"ie %i

ci"cu#at!"ie- $itei %i iei (eete, t"eu"atu"i, c"i'e tetanice, $!a- tau"ine a&ate"e, c!#ici, a&!a%u di#atat, ete!"i% !de"at- !"c, caine (eete, c!#ici, di%nee, de%tinde"ea a&d!enu#ui, dia"ee- t"ataent %!nda2, e$acua"ea c!ntinutu#ui, #a$a2, ca#ante, u"(ati$e- #a $itei %u"ia"ea a#ata"ii 1-7) cu )"ani"ea a"ente"a#a, %a%!#itice,

c!&ate"ea $!ei *et!c#!"aid, !dan%et"!n+, %!#utii ene"(!e#ec"!#itice

39.SINDROM4L DE DILATATIE / TORSI4NE GASTRICA LA CAINE

- di#atatia %t!acu#ui cu "e#a0a"ea #i(, !difca"ea ("eutatii %ecifce B i#eu% ecanicca"dia# %i i#!"ic duat de %t"an(u#a"ea $a%e#!" %an($ine

- %ene c#inice c!#ici ("a$e, di%nee, ta)ica"die, #i%a deeca"ii %i a $!ei, !"i"ea%!ndei #a ni$e#u# ca"diei, c!ntu" "adi!#!(ic a"it

- t"ataent c)i"u"(ica# cu e0ia %t!acu#ui, t"ataent de de%!ca"e, "e)id"ata"e,t"ataent de %u%tine"e, %a%!#itice. Atentie #a ane%te'ie.

3OMAS4L4I- %it!e %"e %tan(a *=@ din ca'u"i+ / #a ni$e#u# ancu#ui %tan(, '(!!t de

c#inc)et "eetat #a 8-18 inute, t"an%"ecta# "uenu# de#a%at %"e i2#!cu# ca$itatiia&d!ina#e, int"e e# %i anc aa"and une!"i ! !"atiune a%eanat!a"e unui %ac

- %"e d"eata e0aen t"an%"ecta# %i in%ecta"ea ancu#ui d"et, %e c!#ica cu

t!"%iune B %u"ia"ea deeca"ii, in"autati"ea %ta"ii (ene"a#e- dia(n!%tic %ene c#inice, e0aen t"an%"ecta#, #aa"at!ie- t"ataent uid!te"aie %i c!"tic!te"aie- t"ataent c!n%e"$ati$ 'i#e in!eta"e, %a%!#itice %i "!%t!(!#i"ea #enta 3 inute,

inte"$entie c)i"u"(ica#a cu e0ie


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- t"ataent edicaent!% a"a%iatic!ietice *&etanec)!#+, antid!aine"(ice*et!c#!"aid+

3=.TRATAMENT4L GASTRITELOR

Se "educe "atia daca $!a nu e%te "e'enta %au %e %u%enda ent"u ce# utin 7 de

!"e"ani"e a"ente"a#aC!&ate"ea de%)id"ata"iiAnti$!iti$e #!ca#e * aa c#!"!!"ata +, e"ie"ice * eeti"a# +, cent"a#e* et!c#!"aid, !dan%ent"!n +, i0te * a"!itant +Pan%aente !0id de a(ne'iu, )id"!0id de a#uiniu, ca"&!nat de ca#ciuA%t"in(ente %a"u"i de &i%ut, tanin, ca!#in, tana#&ina>#!canti ai "ecet!"i#!" )i%tainici cietidina, "anitidina, a!tidina.

3?.ENTEROSPASM4L

Se inta#ne%te in %ecia# #a ca&a#ine %i ai "a" #a "ue(at!a"e, %uine

Stiu#u# $e(etati$ ca"e i# induce e%te (ene"at #a ni$e#u# inte%tinu#ui %au a# #e0u#ui %!#a""in e0une"e #a "i(, aa "ece, i"itatii a"a'ita"e %au de !"din a#ienta".C!nt"actu"a %i di%c)ine'ia a%!ciate cu de%tinde"ea un!"a dint"e an%e "in c!ntinuta#ienta" %i (a'e de e"entatie in u"a i#eu%u#ui %a%tic - (ene"and du"e"e %iente"!atii t!!("afce.

Semne cliniceC!#ica "euati%a#a %au de aa "ece, ca"e %e anie%ta "in c"i'e %cu"te %i e$entua#"eetate de c!#ici, c!n%tiatia, '(!!te inte%tina#e (a'!a%e, daca %a%u# %e "!duce#a ni$e#u# %fncte"e#!" * d!inanta !"t!%iatica +Deeca"e dia"eica daca %a%u# %e e0e"cita in #un(u# an%e#!" inte%tina#e * d!inanta$a(a#a +.

volutivE$!#utie de cate 'eci de in ana #a 7 de !"ePrognostica$!"a&i# cu e0cetia c!#icatii#!" t!!("afce

Tratament:%a%!#itice-%c!&uti#, %c!&uti# c!u%, aa$e"ina, d"!ta$e"ina, n!-%a,"!caina-at"!inaAna#(etice a#(!ca#in, ace"!a'in, &ut!"an!# * ce# ai &un +

[email protected] ASC4LARE A>DOMINALEtiopatogeneza

Ina"cti'a"ea e'ente"u#ui "in a"te"i!%a% e'ente"ic dec#an%at de a"te"itae'ente"ica a"a'ita"a "in inuenta"ea %i%teu#ui neu"!$e(etati$ din $ecinatate.E&!#ie cu !"ni"e de #a a"te"ita e'ente"ica !"i "in a("e(ate t"!&!cita"e indu%e deend!t!0ieie #a ca"e %e adau(a a"te"i!%a%u#.Semne clinice5!"a %u"aacuta c!#ica d"aatica cu t"anti"i %i "!%t!(!#i"i c!ntinue, a"a ca ania#u#%a !ate f %taanit "in c!en'i %au #i&a"e.5!"a acuta c!#ici ("a$e, in c"i'e %cu"te, cu au'e ici5!"a %u&acuta %au c"!nica c!#ici "ecidi$ante %i "e#ati$ u%!a"e de tiu# ent!"%a%u#ui.La unctia a&d!ina#a in !"e#e %u"aacute %i acute %e e0t"a(e #ic)id "!%cat,%an(uin!#entLi%a u#%atiei de e a"te"a e'ente"ica #a e0#!"atia t"an%"ecta#a.

*or+opatologicIna"ct )e!"a(ic e cecu %i;%au c!#!n, e'ente" inf#t"at, #ic)id %e"!)e!"a(ic inca$itatea a&d!ina#a, ane$"i% e a"te"a e'ente"ica.E$!#utie %cu"ta de cate$a !"e, cu $indeca"e %au !a"tePrognostic"e'e"$at


13/25

Pro'la(ie de)e#iinti'a"eTratament %a%!#itice, antic!a(u#ante, antia"a'ita"e

71.ENTERODISTOPII LA CA>ALINE *ENTEROPATII TOPOGRA5ICE+

- "e%uun !difca"ea !'itiei %au;%i a "a!"tu"i#!" uneia %au ai u#t!" an%e

inte%tina#e ata de a#te !"atiuni in a%u"a %a %t"an(u#e'e t"an'itu# di(e%ti$ %ici"cu#atia de int!a"ce"e din an%e#e di%#!cate B ene"!di%t!ii ade$a"ate- di%t!ii#e a#%e %unt ce#e ca"e nu 2enea'a t"an'itu# %i ci"cu#atia din e"ete#e inte%tina#

%i nu int#uentea'a nici di(e%tia, nici inte("itatea inte%tinu#ui %i nici %ta"ea!"(ani%iu#ui in (ene"a#

- "incia#e#e di%t!ii %unt de#a%a"ea, "!tatia, t!"%iunea, $!#$u#u%u#, e0iunea,in$a(inatia, )e"nia %i e$ent"atia.

in u#te ca'u"i in (a%t"! ente"ite#e #a caini %i i%ici dua ce %e !"e%te $!a %ideeca"ea !ate aa"ea in$a(inatia ca"e !ate (ene"a nec"!'a #a ni$e#u# "e%ecti$ %ia!i !a"te.tiopatogenetic

- e"tu"&a"i#e t!nu%u#ui %i !ti#itatii inte%tina#e, indu%e de di%t!nii $e(etati$e- ade"ente#e inc#u%i$ ce#e !%t!e"at!"ii- a"a'itii, de)e#inti'a"i#e, t"aue #!ca#e di$e"%e, )i!0ie #!ca#i'ata, an!a#ii

e#ect"!#itice, i!e#ect"ice- cau'e#e ecanice "e"e'entate de die"ite !"ifcii in ca"e %e !t an(a2a an%e

inte%tina#e, de ine(a#itatea ("eutatii c!ntinutu#ui din die"ite %e(ente di(e%ti$e, de!difca"i &"u%te a#e !'itiei c!"u#ui

P"edi%!'itie #a )e"nii a u"cei#!", $itei#!", catei#!" %au a a"a%a"i#!".

- 2ena %au %u%enda"ea t"an'itu#ui di(e%ti$ cu de%tinde"ea %ect!a"e#!" ante"i!a"e %iade%ea cu di#atatia %ecunda"a a %t!acu#ui, indi(e%tia %i $!a de c!ntinutinte%tina#, "eu#at "et"!("ad i"euna cu tu#&u"a"ea ci"cu#atiei din an%e#e di%t!iate* i%c)eie, nec"!'a, c!a(u#a"e int"a$a%cu#a"a #!ca#a - e"ea&i#i'a"ea $a%ae#!"ici+, ente"!t!0iie

- %ta"ea (ene"a#a aectata "in tu#&u"a"i )id"!e#ect"!#itice %i acid!&a'ice, ci"cu#at!"ii,c!a"tienta#e cu tendinta de "!("e%ie %"e %!c !c#u%i$.

Semne clinice- c!#ici ("a$e, %u%enda"ea atetitu#ui %i a deeca"ii, ete!"i% inte%tina# cu

de!"a"e )i!(a%t"ica, aut!a%cu#tatie in anc, "ect (!#, )i!t!n %i tai%at cu ucu%c!a(u#at - %enu# &"atu#ui %i a te"!et"u#ui

- %ene f'ice #a e0#!"atie t"an%"ecta#a- %e"!'itate "!%cata #a unctia a&d!enu#ui, dete"i!"a"ea %ta"ii (ene"a#e %i a

ci"cu#atiei cu tendinta de a("a$a"e ana #a %!c !c#u%i$

- $!ita"ea de c!ntinut eca#!id.!iagnostic: %ene c#inice, e0aen "adi!#!(ic cu %i a"a t"an'it &a"itat, e0aenec!("afc, end!%c!ie*or+opatologic- %c)i&a"ea !'itiei an%ei "e%ecti$e, e$identiata "in c!n(e%tie #!ca#a, ede,

init"at )e!"a(ic, (an("ena- e0t"a$a'a"ea a&d!ina#a de c!ntinut "!%cat in ca$itatea e"it!nea#a- #e'iuni c!n(e%ti$!)e!"a(ice %i;%au de(ene"ati$e #a ni$e#u# !"(ane#!"

a"enc)iat!a%e.volutii- e$!#utie %u"aacuta %au acuta, "!(n!%tic "e'e"$atTratament:

- %!nda2 (a%t"ic- %a%!ana#(etice- c!&ate"ea di%eta&!#iei %i aut!int!0icatiei- c!&ate"ea %!cu#ui- unctia cecuu#ui %au a c!#!nu#ui di#atat de (a'e


14/25

- #aa"at!ie, ente"!t!ie, ente"ect!ie

7.ENTERODISTOPII LA >OINE SI CARNIORE- >!$ine in$a(inatii#e 2e2unu#ui, e$!#uea'a cu c!#ici, #i%a deeca"ii, di#atatia

a&!a%u#ui- di#atatia %i t!"%iunea cec!-c!#ica, %ind"! de !&%t"uctie, den%itate de ti (a'!%

- t"an%"ecta# in ata &a'inu#ui e d"eata, ! !"atiune %e"ica aa"e #a !$ine %e'i!nie"- Ca"ni$!"e %i !ni$!"e In$a(inatia %i $!#$u#u%u# c!#ici, &a#!na"ea a&d!ina#a, #i%adeeca"ii, $!itat eca#!id. Identifca"ea unei !"atiuni %e"!ide %i den%e #a a#atiat"an%a&d!ina#a. E0aen "adi!#!(ic cu t"an'it &a"itat %i ec!("afc

- T!"%iunea cec!c!#ica aa"e dat!"ita adini%t"a"ii in tainu"i "ea "a"e %i ai$!#uin!a%e

- e"nii#e in($ina#e %i !&i#ica#e

73.METEORISM4L INTESTINAL- %e ca"acte"i'ea'a "in di%ten%ie "aida %i ("a$a, te ti (a'!%, a a&d!nenu#ui, in

indi(e%tii#e "ia"e, "e#ati$ ta"di$a %i !de"ata in ce#e %ecunda"e, a#atu"i de #i%adeeca"ii %i atu#entei, inta#nindu-%e a"!ae e0c#u%i$ #a ca&a#ine

- in ca'u"i ("a$e tu#&u"a"i "e%i"at!"ii %i ci"cu#at!"ii, #e'iuni c!n(e%ti$!-)e!"a(ice,"utu"a %t!acu#ui, inte%tinu#ui, dia("a(ei

- e$!#utie %u"aacuta %au acuta de ce# u#t cate$a !"e- "!(n!%tic "e'e"$at %"e ("a$- t"ataent %!nda2 (a%t"ic, %a%!ana#(e'ice, %u%tine"ea ci"cu#atiei, inte"$entia

c)i"u"(ica#a, unctia ca"2ei ceca#e %au a c!#!nu#ui %i adini%t"a"ea deantie"ente%ci&i#e

77.INDIGESTIA INTESTINALA PRIN S4PRAINCARCARE TRATAMENT

- t"ataent #i&e"tatea de i%ca"e, &u%ua"i, a#atii- dieta a#ienta"a u"a2e #ic)ide, %ei#ic)ide, a%te- )id"ata"ea !"tata, %!nda2 %i e$etua# unctie ceca#a, a c!#!nu#ui- #a0ati$e u#ei!a%e a%a2 c#i%e, #a0ati$e ine"a#e a"a%iatic!ietice- inte"$entie c)i"u"(ica#a- t"ataent de %u%tine"e %i ent"u de%!ca"e

78.STENOZELE SI DILATATIILE INTESTINALESTN", INTSTINAL- tiopatogeneza:- cicat"ici "et"acti#e %au "!#ie"a"i in #uenu# inte%tina# * tu!"i, (a%t"!atie i#!"ica

)iet"!fca +, ente"!%a%u#, ente"!di%t!ii- c!"e%iuni %au %t"an(u#atii intetina#e "in ade"ente e"it!nea#e, #i!n!du"i

e'ente"ice a"ite, tu!"i, c!#ectii a#e (#ande#!" e"iana#e, )ie"t"!fa !%tatei %aua &u"%ei #ui 5a&"iciu%, c)i%ti !$a"ieni

- at!(enetic %ten!'e#e 2enea'a t"an'itu# di(e%ti$ a$!"i'and !"duce"ea indi(e%tii#!""in %u"ainca"ca"e

- !ate %a (ene"e'e %!c !c#u%i$- de "e(u#a cedea'a %!ntan %au "in t"ataent da" "ecidi$ea'a #a inte"$entia un!"

act!"i !ca'i!na#i- an%e#e inte%tina#e ante"i!a"e %e di#ata %i )ie"t"!fa'a ia" u#te"i!" di#atatie inte%tina#a

)i!t!na, indi(e%tie %au !&%t"uctie.- Semne clinice: c!#ici %i c!t"!%ta'a "ecidi$anta, tene%ne) #i%a atu#entei %i

di#atatia %e(ente#!" di%u%e c"ania#e, %a&i"e, date a#at!"ii %i %ene "adi!#!(icecu t"anit &a"itat

- di#atatia a&d!enu#ui- une!"i !t e$!#ua cu eca#e a%t!a%e %au !i %i atu#enta, %a#&i"e "!("e%i$a %i

di#atatia a&d!ina#a- c!nt"!#u# nec"!%ic "e#e$a %ten!'a %i cau'a ei e #an(a di#atatia an%ei inte%tina#e

dinainte.


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- "!(n!%ticu# e%te cu $a"iatii dua #e'iunea %ten!'anta / "e'e"$at- tratamentul "e'!#$a"ea c!"!%ta'ei %i inte"$entia c)i"u"(ica#a!ILATATII INTSTINAL- tiopatogeneza- Neu"!atice de tiu# i#eu%u#ui a"a#itic in u"a un!" #e'iuni edu#a"e %au $a(a#e- Ma#!"ati$ %e "e'enta ca e(ac!#!n c!n(enita# %au "in e"%i%tenta di$e"ticu#u#ui

MecFe#- i!t!nie "a)itici, a"a'iti%, (an(#i!nita e'ente"ica, di%aut!n!ie- Se a$!"i'ea'a acuu#a"ea de c!ntinut, indi(e%tie "in %u"ainca"ca"e %au !&%t"uctii

inte%tina#e "ecidi$ante.- %ene c#inice aetit ca"ici!%, %#a&i"e, c!n%tiatie %i c!#ici "ecidi$ante, di#atatie

a&d!ina#a, inc!n%tant tene%ne- date tacti#e %i de ia(i%tica- di#atatia un!" an%e cu in(e%tie %i (a'e- tratament %a%!#itice, dea"a'ita"e, t"ataentu# "a)iti%u#ui, ne$"!%tenice %i

"e$u#%i$e e '!na #!&a"a, #i&e"tate de i%ca"e, a#ientatie dietetica- inte"$entie c)i"u"(ica#a

79.ENTERITELE PERINATALILOR SI NEONATALILOR ETIOPATOGENEZAActiunea ai u#t!" a(enti eti!#!(ici i"euna cu c!nditii a$!"a&i#e

- act!"i ate"ni a#ientatia utand "!$!ca di%t"!fa %i c)ia" ci"!'a )eatica a atu#ui- act!"i nut"iti!na#i a#ientatia $itei#!" %i u"cei#!"- act!"i inecti!%i E. c!#i, C)#!%t"idiu e""in(en%- act!"i iun!#!(ici c!n%uu# de c!#!%t"u *in ca' c!nt"a" %cade nua"u# de

iun!(#!&u#ine+- act!"i (enetici- act!"i '!!i(ienici a%i(u"a"ea c!nditii#!" de ic"!c#iate %i de'inectia ada!%tu"i#!"

a"e #!c ! ie"de"e de aa %i e#ect"!#iti, in tu&u# di(e%ti$ c"e%te n". de &acte"ii,

c"e%te" u"eia, )e!c!ncent"atie, %cade (#iceia

7


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- Ente"ite #!ca#i'ate du!denita * e&"a, %u&icte" ecanic, c!a+, c!#ita * eca#e(#e"!a%e, atu#enta+, "ectita *tene%ne, deeca"i "ec$ente %i cu cantitati ici %ic!aate cu ucu%, %enu# &"atu#ui +

- dia(n!%tic die"entia# ata de in%ufcienta anc"eatica e0!c"ina, di%e%ia)i!c#!")id"ica, &!#i )eatice %i indi(e%tii "e%t!aca#e.

- tratament i(ien!dietetic, %it!atic, eti!t"!, %i"aicina %i et"!nida'!# ti

de @ de 'i#e

[email protected] PSE4DOMEM>RANOASA

- Aa"e #a "ue(at!a"e, ca&a#ine, e#ine %i a%a"i- M!difca"ea e$identa a %ta"ii (ene"a#e, cu e&"a u"ata de )i!te"ie- Pa"e'ia "e%t!ace#!", c!#ici, c!n%tiatie, u"ata #a cate$a 'i#e de dia"ee, e#iina"ea

de a#%e e&"ane- Le'iuni#e %eud!e&"an!a%e %e identifca in inte%tinu# %u&ti"e %au ("!% #a%ate e

un !nd u#ce"!% %au )e!"a(ic- E$!#utia de ana #a una d!ua %ataani, cu !"ta#itate c"e%cuta- T"ataent %u%tine"ea (ene"a#a, ca#ante a#e c!#ici#!", antiinecti!a%e, &ica"&!nat de

%!diu

81.INS45ICIENTA EPATICA ETIOLOGIE SI SIMPTOMATOLOGIE

- E%te un %ind"! c!#e0, "a" !n!%it!atic ca"e e0"ia incaacitatea fcatu#uide a %ati%ace una %au ai u#te dint"e unctii#e #ui eta&!#ice antit!0ice %au de%inte'a

- Manie%ta"i#e c#inice %unt c!"e%un'at!a"e unctii#!" aectate.- tiopatogeneza- Cau'e a#ienta"e %u"aa#ientatie, %u&a#ientatie, "atii de'ec)i#i&"ate, nut"etu"i

a#te"ate- T!0iinectii, inectii *(ene"a#e, )eatice, de !ca" +- Pa"a'it!'e *%i%teice, )eat!&i#ia"e +- >!#i a#e !"(ane#!" *di(e%ti$e, ci"cu#at!"ii, "e%i"at!"ii, "ena#e +- Reactii iun!a#e"(ice *%t"e%u#+- Int!0icatii *#ante, c)iica#e, ic!t!0ine+- Aut!int!0icatii, %ta"i di%eta&!#ice- Ne!#a'ii di$e"%e- Reacti$itatea %i adata&i#itatea fcatu#ui &!#na$ in ata die"ite#!" %!#icita"i %e di%t"in(

"in a%ine"(ia uncti!na#a in %en%u# c!"!ite"ii un!" unctii %i entine"ii a#t!"a, e#an(a !%i&i#itatea de c!en%a"e uncti!na#a %i din a"tea a#t!" !"(ane

- A%iet"ia #e'i!na#a in %en%u# #e'a"ii un!" !"tiuni a#e fcatu#ui, !data cu entine"eaintacta a )eat!cite#!" din a#te '!ne %au c)ia" cu "!ce%e de "e(ene"a"e *a%ect de

!'aic+- M!"!at!#!(ia )eatica e%te !a"te #a"(a, inceand cu #e'iuni &i!c)iice %i

e#ect"!n!ic"!%c!ice ana #a #e'iuni ac"!%c!ice de ti ci"cu#at!", inaat!",de(ene"ati$, de %c#e"!'a, ci"!'a %au a!t!'a.

- Semne clinice- Manie%ta"i de di%eta&!#ie )id"!e#ect"!#itica de%)id"ata"e, acid!&a'ica *acid!'a+,

"!tidica *)i!"!teineie, di%"!teineie, edee, a%cita, )ie"a!nieieinduct!a"e de encea#!atie )eatica+, (#ucid!#iidica *cet!'a, #i!!&i#i'"e,)ie"c!#e%te"!#eie +, &i#ia"a * icte", "u"it, !t!de"at!'a, %ene di(e%ti$e, u"ina"ede )i!c!#ie %au )ie"c!#ie +

- Tu#&u"a"i en'iatice ain!t"an%e"a'e, !"niti#ca&ai# t"an%e"a'a %au !%ata'aa#ca#ina "in #e'iuni )eat!&i#ia"e

- Tu#&u"a"i $itainice-#i!%!#u&i#e, >-c!#e0.- Tu#&u"a"i )!"!na#e %te"!i'i, )!"!ni ti"!idieni, in%u#ina- Tu#&u"a"i de e0c"etie c!!nenti &i#ia"i, eta#e, nue"!%i )!"!ni, edicaente,

c!#e%te"!#, u"ee, acid u"ic


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- Tu#&u"a"i a#e unctiei antit!0ice %cade"ea neut"a#i'a"ii t!0ine#!" %i cata&!#iti#!",encea#!atie )eatica

- Tu#&u"a"i de %inte'a %ind"! )e!"a(ic- De"e%ie, di%!"e0ie, a#te"na"e dia"eei cu c!n%tiatia, !difca"i u"iina"e, %#a&i"e,

%tenie, "educe"ea "andaentu#ui, e"tu"&a"i )e!dianiice, de !du#a"e a"eacti$itatii iunita"e, %ene f'ice #a e0aenu# fcatu#ui

- In unctie de "e'enta %i e0"e%i$itatea anie%ta"i#!" %e di%tin(e ! a"e in%ufcienta)eatica cu anie%ta"i !"!c#inice e$idente %i ica in%ufcienta )eatica,e0"iata %te"%, atiic, une!"i c)ia" #a te%te#e de #a&!"at!".

8.DIAGNOSTIC SI TRATAMENT IN INS45ICIENTA EPATICA

!iagnosticIntaina in (ene"a# difcu#tati. E# %e &a'ea'a e %ene#e c#inice, e date#e e0aenu#ui de#a&!"at!", a#te anie%ta"i a#e &!#ii "ia"e * )eatita, )eat!'a, c!n(e%tie )eatica,ci"!'a, inectii, int!0icatii +. Pent"u dia(n!%ticu# eti!#!(ic "e'inta i!"tanta %i date#eanc)etei c#inice %i nut"iti!na#e.

Tratamentul- I(ien!dietetic i!"tant t "ecue"a"ea acienti#!". P"e%uune "eau%, c!n!"t

'!!i(ienic, e0c#ude"ea din a#ientatie a %u&%t cu !tentia# )eat!t!0ic. Se ad ina#ientatie )id"ati de Ca, u"a2e $e"'i %au "adacin!a%e, an de ca#itate, #a &!$inee#a%a * 1@@-18@ ( + #a ca"na%ie"e c!!tu"i, &i%cuiti, ceaiu"i.

- Medicaent!% c!"ecta"ea di%unctii#!" )eatice, "!tectia )eat!ce#u#a"a.a& ida"ea c!ntinutu#ui di(e%ti$ * u"(ati$e %a#ine, u#ei!a%e, c#i%e ina#te, "eetate +& C!"ecta"ea in%ufcientei &i#ia"e / ad de u"(ati$e a#ca#ine, u#eiu"i $e(eta#e, &i#a de

&!$inec& C!"ecta"ea in%ufcientei (#ic!"e(u#at!a"e *(#uc!'a 8+, "!tid!"e(u#at!a"e

*ain!aci'i +, adi!"e(u#at!a"e *&i!tina+, $itain!te"aie * $it >+

83.ICTERELE

- icte"u# e%te un %ind"! ca"acte"i'at "in c!#!"a"ea (a#&uie a ie#ii dei(entate, auc!a%e#!" %i a te%utu"i#!".

Pseudoicterul!ate f ! u"a"e a unei ca"!tineii c"e%cute.Icte"u# e%te de 3 e#u"i MECANIC, EPATIC, EMOLITIC

Icte"u# mecanic* &i#ia" + e%te dete"inat de "educe"ea t"an'itu#ui &i#ei dat!"ita "e'enteide !&%t"uctii, a"a'iti, cicat"ici, tu!"i %au aden!atii din $ecinatatea cai#!" &i#ia"ee0t"a)eatice.Dat!"ita &i#ei %ca'ute din inte%tin, %cade e"i%ta#ti%u#, di(e%tia %i a&% "!teine#!",

("a%ii#!" %i $itaine#!" #i!%!#u&i#e, !data cu in%ta#a"ea di%aetentei %i tendintei #ac!n%tiatie, eca#e dec!#!"ateDat!"ita "!ce%e#!" inaat!"ii * an(i!c!#ita, c!#eci%tita + e$! %i cu a#te %it!e * e&"a,#euc!cit!'a, neut"!f#ie, du"e"e #a a#atia "!unda +

Icte"u# .epaticdat!"at #e'iuni#!" )eat!cite!" ca"e de$in )ie"e"ea&i#eH, e"itandt"ece"ea &i#ei in %an(e %i "ea#i'and a%te# icte"u# "in )ie"e"ea&i#i'a"e !"i "e(u"(ita"e.Cu#!a"ea (a#&ena e%te !a"te e$identa %u& !"a de icte" "ancH, uc!a%e#e, ie#ea %i a#tete%utu"i #uand un a%ect "!%cat. Aa"e inaetenta, de%)id"ata"e, %ene ne"$!a%e, u"ina"e *c!#u"ie, c!a#u"ie +

Icte"u# .emolitic%e inta#ne%te in )e!%!"idi!'e, )e!(#!&inu"ii a "i(!"eH, une#e

int!0icatii * Cu, P&, a"%enic +, in une#e $i"!'e, #et!%i"!'a %i une#e inectii cu (e"eni)e!#itici * C#!%t"idii, %t"et!c!ci +. Pie#ea %i uc!%e#e / cu#!a"e %u&icte"ica, di%c"eta,nuanta cit"ina.E%te duat de %ene#e aneiei )e!#itice * aneie, )e!(#!&inu"ie, )eat!c"it "edu%,S acce#e"at.


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Icte"u# n!u-na%cuti#!" !ate f c!n(enita# %au in%ta#at dua na%te"e * %ta'a de ec!niu,inectii !&i#ica#e+, )eatic * t!0ine, inectii + %i )e!#itic. Icte"u# )e!#itic %e inta#ne%te #acata"a%i, an2i %i u"cei.

!iagnostic

C#inic e%te u%!" de u%.Dia(n!%ticu# eti!at!(enetic "in unctie )eatica %au "!&e#e de inca"ca"e )eatica* d!'a"ea t"an%aina'e#!", a#d!#a'e#!", a"ecie"ea &i#i"u&inei di"ecte %i indi"ecte +.Pent"u n!u na%cuti dia(n!%ticu# %e ace "in a(#utina"ea )eatii#!".

volutiaDeinde de eti!at!(ene'a, $a"%ta, a(entu# at!(en

PrognosticulDeinde de ("a$itatea icte"u#ui find a$!"a&i#, "e'e"$at %au dea$!"a&i#.

Tratamentul

E%te in unctie de a(entii cau'a#i %i %e "ea#i'ea'a ca #a in%ufcienta )eatica, icte"u# find !!"a de anie%ta"e a ace%teia.

87.ENCE5ALOPATIA EPATICA

88.CONGESTIA EPATICA ACTIA SI PASIA

%ongestia activa

Tu#&u"a"e ci"cu#at!"ie ca"e c!n%ta in c"e%te"ea de&itu#ui %an(uin #a ni$e#u# fcatu#ui.

tiopatogenezaAa"e dua c!n%uu# nut"etu"i#!" a#te"ate, #ante t!0ice in cantitate "edu%a, dua e!"tu"ia"i %i %u"ainca#'i"e in e"i!ada de de&it a tutu"!" &!#i#!" inect!c!nta(i!a%e, e0! %iend!int!0icatii di$e"%e#!" !t!de"at!'e c!ntu'ii $i!#ente a "e(iunii )eatice.

*or+opatologie5icatu# e%te a"it in $!#u, a"(ini "!tun2ite, cu#!a"e &"un "!%cata, ca%u#a %u& ten%iune,e %ectiune %e %cu"(e ! cantitate a"e de %an(e. Re'i%tenta !"(ani%u#ui e%te n!"a#a%au %ca'uta. Daca c!n(e%tia e%te c!n%ecinta t"auati%e#!", aa" ici )e!"a(ii%u&ca%u#a"e in fcat.

Simptomatologie

C!#ici %u"de, ne#ini%te, "e%i"atie %ue"fcia#a de ti t!"acic, ca tu#&u"a"i "ia"e. P!t fac!e"ite de %ene#e &!#ii "ia"e * int!0icatii, indi(e%tii + cand e#e %unt %ecunda"e. 5eca#edia"eice %i %u"ac!#!"ate $e"'ui.P!#iu"ie cu c!nc a"e in i(enti &i#ia"i %i )ie"a'!tu"ie, a'!teia e%te #iite#e n!"a#ea#e %eciei )ie"(#iceie.La a#atie %i e"cutie, %e in"e(i%t"ea'a atitate c"e%cuta, %en%i&i#itate.

!iagnosticNu e%te u%!" de %ta&i#it. >!a#a !ate t"ece ne!&%e"$ata de!a"ece %it!at!#!(ia "ia"aac!e"a %ene#e "in ca"e %e anie%ta ea.E0 ate"ii#!" eca#e, u"ina, %e" %an(uin, %ene f'ice %i anane'a.Dia(n!%tic die"entiat cu aectiuni#e acute a#te tu&u#ui di(e%ti$ * c!#ici+, &!"&!"i(einte%tina#e.

%ongestia pasiva


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C!n(e%tia a%i$a %au c"!nica c!n%ta in %ta'a unei cantitati a"ite de %an(e #a ni$e#u#fcatu#ui.

tiopatogenezaC!n%ecinta un!" tu#&u"a"i (ene"a#e, ai "a" tu#&u"a"i #!ca#e.

Deinde de u#te !"i de in%ufcienta ca"diaca, fcatu# find una dint"e %uae#eH c!"du#uiin%ufcient.Tu#&u"a"i t!!("afce (a%t"!inte%tina#e %i %#enice, i("a"ea a"a'iti#!" * %t"!n(i#i +.

*or+opatologicMa"iea in $!#u a fcatu#ui, cu#!a"e ai inc)i%a, a%ect fcat ca"diacH, e$identie"ea#!&u#atiei "in c!ntu"u# "!%iatic a# #!&i#!". Pe %ectiune cu"(e ! cantitate a"ita de %an(e$en!%. C!nc!itent #e'iuni#e &!#ii "ia"e di#atatie ca"diaca, a"i"ea (an(#i!ni#!"edia%tina#i, a%cita.

SimptomatologicSene#e %unt ac!e"ite de in%ufcienta ci"cu#at!"ie, ca"di!atii, #eu"e'ii, e"ica"dite.

S!n!#enta #a %cu"t ti dua c!n%ua"ea tainu#ui, aetit ca"ici!%, a#te"na"i dec!n%tiatie %i dia"ee cu i"!% at"un'at!" din cau'a e"entatiei. Muc!a%e# aa"ente"e'inta %u&icte", aneie * in%ufcienta )eat!!etica +4"ina c!nc, &!(at i(entata dat!"ita &i#i"u&inei. Ra!"t !#ietide;u"ee c"e%cut in %an(e.La a#atie %e c!n%tata a"i"ea a"iei )eatice a"a %en%i&i#itate e"ceti&i#a.

!iagnosticDifci#, de!a"ece %ene#e %unt ac!e"ite de tu#&u"a"i#e ci"cu#at!"ii ca"e %unt ai e$idente.Dia(n!%tic die"entia# %e ace cu ci"!'a )eatica )ie"t"!fca * u"!&i#inu(enu"ie c"e%cuta +Dia(n!%ticu# "eci% %e %ta&i#e%te cu &i!%ie )eatica.

TratamentDe !"din %it!atic.Inc#ude "eau%, a#ientatie dietetica, (#uc!'a, a#ca#ine %i a#te i2#!ace ca #a in%ufcienta)eatica.

T"e&uie duat de in#atu"a"ea cau'e#!" adica t"ata"ea in%u ca"diace.

89.R4PT4RA 5ICAT4L4I

Rue"e a !"(anu#ui cu aa"itia c!n%ecuti$a a )e!"a(iei, fe %u&ca%u#a"a %u& !"a de)eat! fe "in "ue"ea ca%u#ei )eatice, ducand #a )e!e"it!neu.

tiologie

Ania#e#e ca"e "e'inta di%t"!fe )eatica, di%t"!fe ("a%a, c)i%ti a"a'ita"i.A&ce%e#e, "in de%c)ide"ea #!" "e"e'inta un i2#!c de "a(i#i'a"e a fcatu#ui.Actiuni ecanice %au t"auati%e !de"ate * accidente, #!$itu"i, c!ntentie ("e%ita, etc +La a%a"i ce#e ai u#te "utu"i %unt "!du%e in tiu# !uatu#ui.

*or+opatologicLa de%c)ide"ea ca$ a&d!ina#e %e !&% )e!e"it!neu, )eat!ae %u&ca%u#a"e,c)ea(u"i %au "ete#e de f&"ina in%e"ate e %u"aata de "utu"a a fcatu#ui. T!ate te%utu"i#eaneice, in de e"it!neu, cand "utu"a %e "!duce nuai %u&ca%u#a".

Simptomatologie

E%te inte""eta&i#a %i in%ufcienta t a "eci'a dia(n!%ticu#.Ania#u# "e'inta &"u%c ! %ta"e "ea, aatie, c!#ici a#%e. Muc!a%e#e aa"ent de$in aneice,u#% ute"nic !difcat, ten%iune %ca'uta %au c!#et di%a"uta. Pa#iditatea ie#ii #a u"cei,)!"ii#atie, "e%i"atie "ec$ de ti t!"acic, a#iditatea c"e%tei #a a%a"i.


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La ca# %i ce#e#a#te %ecii, aneia "!("e%i$a %i in%ta#a"ea c!#a%u#ui ci"cu#at!", aa"itia de%an(e #a unctia ca$ a&d!ina#e.

!iagnosticDe%tu# de ("eu de u%.Anane'a, aneia "!("e%i$a, %ta"ea (ene"a#a "!a%ta, #ic)id a&d!ina# )e!"a(ic, %e

inta#ne%c %i in a#te "utu"i $i%ce"a#e.Date c#a"e cu #aa"!%c!ie %au #aa"at!ie.

volutieDeinde de ("a$itatea "utu"ii. Ania#e#e !" in 1@-1 !"e de #a accident. e!"a(ii#e%u&ca%u#a"e %e $indeca in 8-< 'i#e.

PrognosticInt!tdeauna ("a$

TratamentReau%, ca#ante, a#icatii "eci e a"ia )eatica, t"ataent )e!%tatic e ca#e (ene"a#a.

T"ataent de c!&ate"e in ca'u"i#e ai nue"!a%e.

8


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Aa"e dua anuite &!#i e0. Ca# cu (u"a %au &!a#a ("e&anu#ui, c!#ectii %etice.

volutiai!%ie t date "eci%e.

Dia(n!%tic di cu "eticu#!e"it!nita, "eticu#!dia"aatita, e"it!nita #!ca#i'ata, %ind"!

!und.

volutie

E$!#utie "aida, aa"e %eticeie.

P!%i&i#itate "idicata de a %e %a"(e un a&ce% ca"e %a "!duca e"it!nita #!c %au (en, ieie

ata#a.

Prognostic

Dea$!"a&i# in ca'u# unui a&ce%, ("a$ in ca'u# ce#!" u#ti#e.

Tratament

I(ien!dietetic, %tiu#ente (ene"a#e %i antiinecti!a%e.

Inte"$entie c)i"u"(ica#a e"ite $ida"ea a&ce%e#!" unice.

8?.CIROZA EPATICA


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JFi")!%H B (a#&en u"da"

Aa"e in u"a actiunii tutu"!" n!0e#!" de #a )eat!atii#e acute. 5"ec$ "e#ati$ a"e #a

ania#e#e d!e%tice caine, !"c, &!$ine, !i, ca# %i "a" a%a"i#e, ieu"ii %i c!&aii.

tiopatogeneza

C!ntinua"ea )eat!atii#!" t"enante, de ti de(ene"ati$, ci"cu#at!" %au inaat!".4"a"ea inectii#!" * &acte"i!'e, $i"!'e +, actiunii t!0ice#!" ic"!&iene %au a"a'ita"e, t!0ice

eta#e, %ta"i de a$itain!'a, in (ene"a# t!ate cau'e#e ca"e %tau #a &a'a de(ene"a"ii

fcatu#ui.

*or+opatologic

5icatu# a"it in ci"!'a )ie"t"!fca %au ic%!"at in ci"!'a at"!fca, in a&e#e ca'u"i

"e'entand '!ne ai de%c)i%e #a cu#!a"e, J%ca"taitH #a %ecti!na"e.

In ci"!'a )ie"t"!fca )eat!e(a#ie, c!n%i%tenta du"a, cu#!a"e &"un "!%cata, &en'i

a#&ici!a%e ne"e(u#ate.

4"e "e'ente de #a i("atii#e #a"$a"e * a%ca"i'i #a !"c, %t"!n(i#i #a cai +

Simptomatologie

%iroza icterigenaLa inceut a&ate"e, %!n!#enta, inaetenta, aetit ca"ici!%, a#te"na"i c!n%tiatie-

dia"ee. 4"ina %u"ac!#!"ata, "e(a%indu-%e i(enti &i#ia"i %i u"!&i#in!(en.

D!inant %u&icte" %au icte", tu#&u"a"i (ene"a#e di(e%ti$e %i "e%i"at!"ii.

E0 f'ic atitate a&%!#uta, c!n%i%tenta du"a.

%iroza ascitogenaIn a'a "ea%citica, %ene neca"acte"i%tice di%!"e0ie, ica, a#te"na"i c!n%tiatie dia"ee.

La ca# dete"ina c!#ici, u"!&i#inu"ie a%i$a, %ta"ea uc!a%e#!" aa"ent n!"a#a

Ania#e#e %#a&e%c "!("e%i$, #i%ite de $#a(a, !&!%e%c "eedeIn a'a a%citica acuu#a"ea #ic)idu#ui a%citic * a%ect de Jantece de &at"acianH +

Sene f'ice #a %ind"!u# de a%cita

!iagnostic

Ci"!'a icte"i(ena e &a'a %ene#!" c#inice, uncti!na#e, e0 f'ic a# fcatu#ui, >IOP4NCTIE

* %e c!n%tata t c!n2uncti$ + "in ca"e %e di ata de ec)in!c!c!'e * %e c!n%tata t )eatic

a"enc)iat!% +

Ci"!'a a%cit!(ena difci# daca nu %e ac e0#!"a"i#e unctii#!" )eatice * e0 u"ina /

u"i&i#inu"ia +.

volutie

Gene"a# c"!nica, icte" ("a$ ca"e %e ae#i!"ea'a $a"a

Prognostic

Dea$!"a&i# de!a"ece "!ce%u# %c#e"!tic !data in%ta#at e%te i"e$e"%i&i#.

Tratament

Eecte "edu%e

Se !#!%e%c i2#!ace#e de #a in% )eatica t "ec!nditi!na"ea ania#e#!" t a&at!".

9@. ANGIOCOLITA. COLECISTITA. COLELITIAZA


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Sunt inaatii a#e cana#e#!" &i#ia"e e0t"a)eatice %i "e%ecti$ a#e $e'icii &i#ia"e. Se

inta#ne%c "ec$ent #a "ue( , ai "a" #a caine, ca# %i !"c.

tiopatogeneza

A%cendent e ca#e canicu#a"a

De%cendent, "in inectii )eat!(ene inectii &acte"iene, cata" a# cai#!" &i#ia"e, icte"

cata"a#Pa"a'itii cai#!" &i#ia"e, ca#cu#!'a &i#ia"a

*or+opatologic

Le'iuni $a"ia&i#e %i#e cata"u"i, #e'iuni u"u#ente, %c#e"!a%e ca"e det di%t"u(e"ea "in

c!"e%iune a t a"enc)iat!%. La "ue( in("!%a"ea c!#ed!cu#ui, cana#u# ci%tic,

)eat!e(a#ie !de"ata, %u&icte".

Simptomatologie

G"eu te inte""etat. Se !&%e"$a de ce#e ai u#te !"i #a nec"!%ie %au %e &anuie%c e &a'a

a(enti#!" eti!#!(ici * !ua de a"a'iti in eca#e +.

Sene c#inice di%!"e0ie, tendinta de c!"!%ta'a, %#a&i"e, %cade"ea "!ductiei, e&"a %i

"eactie #euc!cita"a de %uu"atie, une!"i c!#ici a#%e, icte" ecanic %i du"e"e #!ca#a.

!iagnostic

Se "eci'ea'a d!a" "in e0aen R!ent(en, #aa"!%c!ie %au #aa"at!ie.

volutie

Lun(a du"ata %i !%ci#anta. E$!#uea'a cu %ene c#inice in e"i!ada de %ta&u#atie, %i %e

ae#i!"ea'a in %e'!ane#e de "e(i $e"de * "ia$a"a, $a"a t!ana +. >!a#a de$ine

e$identa cand a"a'it!'e#e nu au !%t t"atate.

Tratament

Re(i i(ien!ditetic adec$at, a#ca#ine, anfinecti!a%e, ca#ante, t"ataent eti!#!(ic

* dea"a'ita"e + K

Litiaza iliara!ate f cana#icu#a"a da" ai a#e% $e'ica#a. Mai "ec$enta #a "ue( %i caine.

tiopatogeneza

Di%c)ine'ii &i#ia"e, duate de "!ce%e inaat!"ii e cai#e &i#ia"e.

Ca#cu#ii %unt c!u%i din &i#i"u&ina, c!#e%te"ina, %a"u"i de Ca.

*or+opatologie

Se t"aduce "in c!#eci%tite c"!nice, c!#an(ite acute %au c"!nice cu !"i"ea t"an'itu#ui &i#ia",

di#ata"ea cana#e#!", f&"!'a"ea e"eti#!".

Ca#cu#ii !t "!duce %i "ue"ea cana#e#!" &i#ia"e.

Simptomatologie

Manie%ta"i c#inice ne%ecifce.

A#te"na"e dia"ee c!n%tiatie. C!#ica )eatica du"ea'a -3 !"e a!i ania#u# %e #ini%te%te,

icte"u# di%a"e in 1- 'i#e.

Ania#e#e ici !t "e'enta $!ita"i, une!"i e0u#'ea'a ca#cu#ii "e%ecti$i.

La ca# %e anie%ta "in %#a&i"e, c!#ici "ecu"ente, a&ate"e, de%)id"ata"e, uc!a%e#e aa"entc!n(e%ti!nate, &i#i"u&ineie c"e%cuta, &i#i"u&inu"ie, %en%i&i#itate c"e%cuta #a ni$e#u#

)i!c!nd"u#ui d"et.

Daca nu %e ai e#iina ca#cu#ii %e a("a$ea'a %ta"ea, inte"$ine %uu"atia, "utu"a e"ete#ui

cana#u#ui, dec#an%a"ea e"it!nitei acute %i %a"%it #eta#.


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!iagnostic

De%tu# de ("eu.

Reeta"ea c!#ici#!" cu aa"itia icte"u#ui u%u"ea'a dia(n!%ticu#.

La ania#e#e ici e0 "adi!#!(ic cu %u&%t de c!nt"a%t.

E0aenu# %an(e#ui )ie"!%!ta%eie, )ie"&i#i"u&ineie di"ecta.

Prognostic:"e'e"$at

Tratament

C!&ate"ea c!#icii "in ca#ante * aa ca#da, at"!ina, C!&e#en + %e"u"i cu e#ect"!#iti,

"e)id"ata"e, t"ataent c!#a(!( t e#iina"ea ca#cu#i#!".

91. PANCREATITA AC4TA SIMPTOME SI TRATAMENT

>!a#a !ate f "!$!cata de u#ti#e cau'e "!a(a"ea un!" inectii in$ecinate * e"it!neu,

du!den, c!#ed!c +, en!ene aut!iune, t"auati%e in '!na anc"ea%u#ui, !&%t"uctia %au

!c#u'ia cana#u#ui i"%un( "in a"a'iti, tu!"i %au c!"e%iuni din e0te"i!".

Simptomatologie

De&utea'a "aid * anane'a +

Manie%ta"i neca"acte"i%tice, &"u%c c!#ica d"aatica,

Ania#e#e "e'inta a&d!en acut ca"e e%te anie%ta"ea c#inica a e0citatie %!#a"e din

cau'a actiunii i"itante a en'ie#!" anc"eatice acti$ate.

La caine %e anie%ta "in #eta"(ie &"u%ca, an!"e0ie, e&"a, tu#&u"a"i di(e%ti$e ("a$e,

$!ita"i, (eete, dia"ee inten%a, du"e"e #a a#atia a&d!enu#ui

La !"c aa"e ai "a", %e anie%ta "in dia"ee J ca ai!ne'aH, %u&e&"i#itate, %#a&i"e,

inaetenta.

Tratament

Se iune dieta nea("a, %a%!#itice, antiinecti!a%e acti$e ata de c!#i * t"acic#ine +,

(#uc!c!"tic!i'i. C!nc!itent ca"di!e0icante, %e"u"i cu e#ect"!#iti.

Dua feca"e a%a "ea"ate anc"eatice * t"ie"ent +, "e(i %a"ac in ("a%ii %i &!(at in

)id"ati de ca"&!n %i "!teine.

9. INS45ICIENTA PANCREATICA EOCRINA

- defcienta in en'ie anc"eatice c!nduce cat"e a#di(e%tie, dia"ee, %#a&i"e

- aa"e "ec$ent #a ci!&ane%tii (e"ani ana in 8 ani, aa"e at"!fa tu%utu#ui acina"anc"eatic cu cau'a necun!%cuta, te%utu# end!c"ine nu e%te aectat / a%te# dia&etu#

nu %e anie%ta- dia(n!%tic "adi!("afe- t"ataent %u#ienta"ea "atiei cu e0t"act u#&e"e de anc"ea% &!$in %au !"cin- )"ana de !"i e 'i, ent"u unii acienti e%te nece%a"a te"aia cu c!&a#aina, daca

dia"eea e"%i%ta %e adini%t"ea'a tet"acic#ina

93.PERITONITELE. DIAGNOSTIC SI TRATAMENT- diagnostic:u%!" de u% #a ania#e#e de ta#ie ica %i ca#, da" ai difci# #a

"ue(at!a"e %i !"c

- %ene de ne#ini%te, $!a, %en%i&i#itate c"e%cuta a&d!ina#, %cade"ea &"u%ca au#%u#ui, (eete, ci!'a- in !"a c"!nica e&"a inte"itenta, %#a&i"e, a#te"nanta de c!n%tiatie cu dia"ee,

c!#ici "ecu"ente, a"e'ia "e%t!ace#!", %ind"! !und, %u&!c#u'ie inte%tina#a ca


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u"a"e a !"(ani'a"ii e0%udatu#ui %u& !"a f&"!a%a *ade"ente+, de a&ce%e,

("anu#!ae- tratament igieno-dieteticB "eau%, a%te"nut ("!%, tee"atu"a !tia, #a0ati$e,

a#iente #ic)ide %au %ei#ic)ide, a#ientatie a"ente"a#a- tratament medicamentos:c!&ate"ea %!cu#ui *%edati$e+ / e$acua"ea #ic)idu#ui

"in a&d!en!cente'a, anti&i!tice (ene"a# %au int"ae"it!nea#

97.ASCITA MAMI5ERELOR- e%te un %ind"! ca"acte"i'at "in acuu#a"ea unei c!#ectii neinaat!"ii in

ca$itatea e"it!nea#a. Aa"itia ei "e%uune un de'ec)i#i&"u int"e ten%iunea

)id"!%tatica %i cea c!#!id!%!tica- aa"e c!n%ecuti$ in in%ufcienta ca"dia, c!"e%iuni#e e $ena ca$a, )ie"ten%iunea

!"ta#a, %eud!e"ica"dite, %ta"i de )i!"!teineie, %cade"ea "a!"tu#ui a#&uina-

(#!&u#ina- %it!at!#!(ie a'a ana%citica B aetit ca"ici!%, di%e%ii (a%t"!inte%tina#e,

c!n%tiatie;dia"ee- a'a a%citica di%ten%ia $ent"a#a a a&d!enu#ui

- "!(n!%tic ("a$- t"ataent #a ania#e#e de "enta %e "ec!anda %ac"ifca"ea de nece%%itate- "e(i i(ien!-dietetic B a#ientatie de a"e $a#!a"e ene"(etica, a"a %a"e- t"ataent edicaent!% B c!&ate"ea &!#ii "ia"e, diu"etice, unctie

98.ASCITA >ROILER-ILOR- %ii#a"a cu a%cita aie"e#!", %unt "edi%!%e ania#e#e %u"a"ec!ce %i ce#e

a#ientate cu nut"et ("anu#at %au #a uii c"e%cuti #a a#titudini de e%te 138@ - ! a#ta cau'a a$!"i'anta !ate f %t"e%u# )6!0ic, defcit de !0i(ent in ae", defcit de

"e%i"atie u#!na"a B "e'u#ta a%te# ! )ie"ten%iune u#!na"a c!en%at!"i da"

ca"e c!nduce #a in%ufcienta de c!"d d"et cu )ie"ten%iune !"ta# %i in fna# a%cita

- "e'u#ta acuu#a"e de #ic)id in ca$. a&d!ina#a, )id"!e"ica"d, ede %u&cutanat,di#atatie c!"d d"et- e$!#utia e%te de %cu"ta du"ata da" !ate inte"$eni !a"tea %u&ita- pro'la(ie si tratament:"educe"ea a(#!e"atiei, defcientei ecani%e#!" de

c#iati'a"e, "educe"ea "atiei 1;eeF, %u#ienta"e cu $it. E %i anti!0idante, #iita"ea

!"ta2u#ui nut"iti!na#, i(iena ada!%tu"i#!"

99.SINDROM4L 5ICAT4L4I GRAS EMORAGIC AL GAINILOR O4ATOARE-

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