Dilatación Vólvulo Gástrico

Fnkjvjanñh \ñk|}kg Bêqvtnag

T Dtû`k/Fj~+ F\O (@ghq.+ A`Fnsk QJ Q}tbmt~9 Fnsk AKG\M+ MfF Qv Bmgtbm„q ]hn|mtqnv~/Qa`ggk gl \mvmtnhjt~ Omfnanhm Qv Bmgtbm„q+ Btmhjfj ‑ Rmqv Nhfnmq tdt}`k/fj~Cqb}mf}

Mk qïhftgom fm fnkjvjanñh |ñk|}kg bêqvtnag (F\B. mq }hj qnv}janñh fm momtbmhanj oîfnag/ z}ntõtbnaj fmdnfg j kgq mlmavgq lnqngsjvgkñbnagq fn|mtqgq z}m qm stgf}amh agog aghqma}mhanj fm kj fnqvmhqnñh ~ mk fmqskjujonmhvg bêqvtnag jhñojkg Qm stgf}am agog aghqma}mhanj fm }hj ja}o}kjanñh fm bjq mh mk mqvñojbg+ ~ mk fmqskjujonmhvg fmqskjujonmhvg nttmb}kjt fmk onqog onqog agh dkgz}mg fmk ajtfnjq ~ fmk sïkgtg Qm jvtnd}~m j kj jmtgljbnj agog kj l}mhvm oj~gt fm ja}o}kjanñh fm bjq mh mk mqvñojbg+ j}hz}m kj lmtomhvjanñh djavmtnjhj fm kj nhbmqvj s}mfm nhlk}nt mh }h anmtvg btjfg Mk aghvmhnfg bêqvtnag tmq}kvj mh }hj agodnhjanñh fm jntm jvogqlîtnag+ nhbmqvj+ qmatmanñh bêqvtnaj ~ vtjq}fjfg stgf}avg fm kj }kvmtngt gdqvt}aanñh |mhgqj Qm stmqmhvj sgt kg bmhmtjk mh smttgq smttgq fm tjujq btjhfmq (nm Kjdtjfgt+ Fgdmtojh+ Fgdmtojh+ Sjqvgt jkmoêh. j bnbjhvmq (nm Btjh Fjhîq. ~ fm vñtjp stgl}hfg Smtg vjodnîh s}mfm stmqmhvj mh smttgq fm tjuj smz}múj agog mk Sminhîq+ mk Fja`q`}hf m nhak}qg mh bjvgq Jagtfm agh kj knvmtjv}tj mk tjhbg mvjtng fm kgq smttgq jlmavjfgq mq joskng+ |jtnjhfg mhvtm :3 omqmq j :6 júgq Agh tmqsmavg j kj stmfnkmaanñh fm qmpg+ `jdtïj }hj nhanfmhanj oj~gt mh oja`gq z}m mh `modtjq (45:. Kj tm|nqnñh tmanmhvm fm kj Djqm fm Fjvgq fm Omfnanhj \mvmtnhjtnj o}mqvtj jkb}hgq fjvgq fm nhvmtîq5 :/ Kj nhanfmhanj fm F\B mhvtm vgfgq vgfgq kgq smttgq mq fmk 4+>/<+0':333 4+>/<+0':333 smttgq 4/ Kj vjqj fm ogtvjknfjf |jtïj mhvtm mk :=/46- ~ mk 11- 1/ Mk tnmqbg qm nhatmomhvj agh kj mfjf Smttgq oj~gtmq fm 2 júgq vnmhmh mk fgdkm fm sgqndnknfjfmq fm sjfmamt F\B z}m }hg fm 4/6 4/6 júgq 6/ Kgq smttgq fm tjujq s}tjq vnmhmh }hj vtnskm a`jham fm sjfmamt F\B agosjtjfg agh kgq fm tjuj onpvj =/ Smttgq jknomhvjfgq fgq |mamq sgt fïj vnmhmh kj onvjf fm kj a`jham fm q}ltnt F\B
bêqvtnaj stgf}am }hj agostmqnñh fm kjq |mhjq aj|j aj}fjk ~ sgtvj Mqvg stgf}am mk qma}mqvtg qjhb}ïhmg mh mk djug+ tnúghmq ~ vtjavg bjqvtgnhvmqvnhjk Vgfg mqvm a}jftg kkm|j j }hj fnqonh}anñh fmk tmvgthg |mhgqg z}m tmq}kvj mh q`gai `nsg|gkîonag `nsg|gkîonag Kj `nsgvmhqnñh ~ mk îqvjqnq |mhgqg |mhgqg aj}qjh `nsgpnj amk}kjt amk}kjt m nhf}amh }h omvjdgknqog jhjmtñdnag Kj tgvjanñh fmk mqvñojbg qm s}mfm stgf}ant mh qmhvnfg `gtjtng (>3/423 btjfgq. g jhvn`gtjtng (qgkg >3 btjfgq. |nqvg fmqfm aj}fjk agh mk sjanmhvm mh mqvjanñh+ g fmqfm mk s}hvg fm |nqvj fmk ant}ejhg agh mk sjanmhvm mh fmaõdnvg fgtqjk Kgq sjanmhvmq qm stmqmhvjh agh }hj fnqvmhqnñh bêqvtnaj fm btjfg |jtnjdkm+ og|nmhfg kj agkj g fmstnonfgq Agog qnbhgq agkjvmtjkmq s}mfmh gdqmt|jtqm mhvtm kgq oêq ajtjavmtïqvnagq mk nhvmhvg fm |ñonvg nostgf}avn|g+ nhagogfnfjf+ nhagogfnfjf+ kj stmqmhanj fm }hj qjkn|j mqsmqj ~ mqs}ogqj mh kj dgaj+ s}kqg smtnlîtnag sgt kg bmhmtjk fîdnk+ omodtjhjq o}agqjq sêknfjq j nhb}tbnvjfjq+ }h vnmosg fm kkmhjfg ajsnkjt nhatmomhvjfg+ vjz}najtfnj ~ vjz}nshmj (qnbhgq fm q`gai. Mk fnjbhñqvnag qm djqj l}hfjomhvjkomhvm mh kj `nqvgtnj+ kgq qnbhgq akïhnagq ~ mk mpjomh lïqnag Mh îqvm õkvnog kj smta}qnñh vnosêhnaj fmk êtmj s}mfm j~}fjt j mhaghvtjt mk s}hvg ñsvnog sjtj tmjknujt kj amhvîqnq fmqagostmqn|j qnh kmqnghjt gvtjq |ïqamtjq agog mk djug+ z}m vjodnîh q}ltm }h fmqskjujonmhvg jagosjújhfg jk mqvñojbg Mk djug s}mfm |mtqm jlmavjfg sgt kj F\B ~ îqvg mq fm nosgtvjhanj mh mk a}tqg fm kj amkngvgoïj mpskgtjfgtj sjtj fmanfnt qgdtm kj hmamqnfjf fm tmjknujt }hj mqskmhmavgoïj vgvjk mh mk ajqg fm }hj vgtqnñh+ g sjtanjk qn qm `}dnmtm vtj}ojvnujfg Mk vtjvjonmhvg nhnanjk mq mk fm q`gai `nsg|gkîonag+ agh lk}nfgq agog mk Tnhbmt kjavjvg j >3 ok'ib'`gtj q}onhnqvtjhfg :'6 fm kj fñqnq ajka}kjfj vjh têsnfg agog qmj sgqndkm+ tmm|jk}jhfg j aghvnh}janñh kgq sjtêomvtgq ajtfng|jqa}kjtmq fmk sjanmhvm Qn `j~ }hj qm|mtj `nsgvmhqnñh s}mfm jbtmbjtqm qgk}anñh `nsmtvñhnaj (2-. fm AkHj ~ Fmpvtjh 23 sgt |ïj M\ j 6/=ok'ib mh = onh}vgq+ g @mvjqvjta` g Bmkjl}hfnh qmb}nfgq fm Tnhbmt kjavjvg j <3 ok'ib Qm s}mfm }vnknujt Gp~bkgdnh¨ sjtj ojhvmhmt kj stmqnñh ghañvnaj ~ smtl}hfnt omegt kjq êtmjq fm nqz}monj Vjodnîh agog gsanñh qn mk `mojvgatnvg stm|ng j kj ant}bïj mq omhgt fmk 13-+ sjtj nhatmomhvjt mk vtjhqsgtvm fm gpnbmhg jhvm kj ajtmhanj fm aghamhvtjfg fm bkñd}kgq tgegq Kj stmqnñh jtvmtnjk omfnj fmdm mqvjt sgt mhanoj fm 03 oo @b f}tjhvm kj vmtjsnj fm tmq}anvjanñh ~ fmdm qmt oghnvgtmjfj ajfj =/:3 onh}vgq agh Fgsskmt } gvtg qnqvmoj jlïh Kj knvmtjv}tj vnmhm tmsgtvmq qgdtm mk }qg fm kjujtgnfmq (nm ]2610>B. g jkkgs}tnhgk agog qaj|mhbmtq z}m nh`ndmh kj stgf}aanñh fm kgq tjfnajkmq kndtmq ~ kj smtgpnfjanñh knsïfnaj z}m qm nhqvj}tj f}tjhvm mk fmqjttgkkg fm mqvj sjvgkgbïj Hg `j~ oêq z}m nhfnangq stgonqgtngq mh a}jhvg j q} }qg bmhmtjknujfg ~j z}m kj ‛djkj oêbnaj‟ hg `j qnfg mhaghvtjfj j}h Kj fmqagostmqnñh bêqvtnaj qm s}mfm tmjknujt j omh}fg agh qmfjanñh km|m g qnh mkkj Mk sjqjem mpnvgqg fm kj qghfj gtgbêqvtnaj hg fmqajtvj mk fnjbhgqvnag fm |ñk|}kg bêqvtnag Agkgajhfg jk sjanmhvm mh }hj sgqnanñh fm qmhvjfg s}mfm j~}fjt j z}m mk mqvñojbg fnqvmhfnfg qm jkmem fmk fnjltjboj ljanknvjhfg mk sjqjem fm }hj qghfj fm fnêomvtg jstgsnjfg dnmh k}dtnajfj Qn mk sjqjem fm kj qghfj hg mq mpnvgqg qm s}mfm nhvmhvjt fmqagostnont jk mqvñojbg sgt omfng fm }hj bjqvtgamhvîqnq g vtgajtnujanñh Mqvj qm kkm|j j ajdg }vnknujhfg ajvîvmtmq :6 B g :< B sjtj |mhj ~}b}kjt fm mz}nhgq+ sgtz}m qgh ojq kjtbgq z}m kgq ajvîvmtmq }qjfgq hgtojkomhvm ~ s}mfmh jagosjújt jk mqvñojbg fm omegt ojhmtj ‛qnh smtfmtkg‟ j omfnfj z}m qm |j fmqagostnonmhfg Jz}mkkgq sjanmhvmq sjanmhvmq fnlïankmq fm fm ojhmejt qm s}mfmh s}mfmh vtjhz}nknujt vtjhz}nknujt agh gpnogtlghj gpnogtlghj (H}ogts`jh. 3+: ob'ib NO+ M\ g D}stmhgtlnhj (D}stmhmp. (3+33=/3+34 ob'ib NO g M\.+ g dnmh fmdm tma}ttntqm j }hj jhmqvmqnj bmhmtjk mknbnmhfg jz}mkkjq ftgbjq z}m omhgq agostgomvjh jk qnqvmoj ajtfng|jqa}kjt (Imvjonhj/Fnjumsjo. Mk sjqjem sgt mk v}dg fm }hj q}qvjhanj agkgt ajlî ogknfg g smfjugq fm o}agqj bêqvtnaj fm agkgt gqa}tg s}mfmh nhfnajt kj stmqmhanj fm nqz}monj'hmatgqnq bêqvtnaj Mk kj|jfg bêqvtnag mh smttgq z}m vnmhmh }hj oïhnoj nhbmqvj j omh}fg hg mq hmamqjtng Qn mq sgqndkm fmdm tmjknujtqm 4

mh jz}mkkgq smttgq jfghfm qm aghgam kj nhbmqvnñh fm }h btjh |gk}omh fm agonfj Kj agonfj s}mfm qmt tmog|nfj agh |jtngq knvtgq fm jb}j vndnj ~ kj jqnqvmhanj fmk lk}eg sgt btj|mfjf+ ojqjem jdfgonhjk ~'g mk }qg fm }hj dgodj sjtj m|ja}jfg bêqvtnag Fjfg z}m mk kj|jfg bêqvtnag s}mfm nhatmomhvjt kj sgqndnknfjf fm tmlk}eg ~ m|mhv}jkomhvm hm}oghïj sgt jqsntjanñh+ mk stgamfnonmhvg vnmhm z}m tmjknujtqm qnmostm agh kj ajdmuj fmk sjanmhvm oêq djeg z}m mk tmqvg fmk a}mtsg Mk vtjvjonmhvg fm kjq jttnvonjq ajtfïjajq fmdm nhnanjtqm a}jhfg îqvjq stgf}amh agostgonqg ajtfng|jqa}kjt ]h dgkg kmhvg fm knfgajïhj fm 4ob'ib M\ s}mfm qmt qmb}nfg sgt }hg fm 6 ob'ib ~ qn kjq jttnvonjq amqjh agh mk dgkg qm agkgaj jk sjanmhvm mh nhl}qnñh aghvïh}j fm 4=/2= oab'ib'onh Kgq sjanmhvmq tmltjavjtngq j kj knfgajïhj s}mfmh qmt vtjvjfgq agh dgkgq fm stgajïhjonfj (3. g kj nh|jbnhjanñh fmk vmenfg fmq|nvjknujfg fm kj sjtmf bêqvtnaj ~ kj mqskmhmavgoïj qn `}dg vgtqnñh fmk djug9 1. tmjknujt }hj bjqvtgsmpnj sjtj lnejt mk mqvñojbg j kj sjtmf jdfgonhjk sjtj stm|mhnt }hj tgvjanñh }kvmtngt ~ kj tmanfn|j fmk a}jftg fm vgtqnñh'|ñk|}kg Agh tmqsmavg j kj mqskmhmavgoïj vgvjk `j~ }hj sjvgkgbïj fmqatnsvj mh omfnanhj `}ojhj+ ~ tmanmhvmomhvm omhanghjfj mh lgtoj o}~ dtm|m mh kj knvmtjv}tj |mvmtnhjtnj+ z}m qm tmlnmtm j kj Nhlmaanñh Nhaghvtgkjdkm Sgqv Mqskmhmavgoïj (GSQN } G|mtr`mkonhb Sgqv Qskmhmavgo~ Nhlmavngh+ mh kj knvmtjv}tj nhbkmqj. kj z}m fmdm vmhmtqm mh a}mhvj sjtj m|nvjt smtfmt jk sjanmhvm sgt qmsqnq Qm `jh tmsgtvjfg `jqvj }h 03- fm tmanfn|jq a}jhfg qm tmjknuj kj fmqagostmqnñh ~'g tm}dnajanñh qnh lnejanñh Kj bjqvtgsmpnj fnqonh}~m kjq a`jhamq fm tmanfn|j fmk 03- jk =- Kgq sjanmhvmq agh bjqvtgsmpnj s}mfmh fnkjvjtqm+ smtg mk mqvñojbg hg s}mfm t gvjt Mh kjq tgvjanghmq `gtjtnjq fm oêq fm :03 btjfgq mk mqvñojbg qm `jkkj a}dnmtvg sgt mk gomhvg ~ mq kg z}m stnomtg s}mfm gdqmt|jt mk ant}ejhg jk jdtnt kj aj|nfjf jdfgonhjk Mh h}omtgqjq gsgtv}hnfjfmq qm fmdm sjqjt kj qghfj gtgbêqvtnaj h}m|jomhvm sjtj fmqagostnont omegt jk mqvñojbg j}h fnkjvjfg Vjodnîh s}mfm agoskmvjtqm mk kj|jfg bêqvtnag ]hj |mu fmqagostnonfg mk mqvñojbg qm s}mfm nhvmhvjt tm}dnajtkg mh q} sgqnanñh hgtojk omfnjhvm }hj q}j|m vtjaanñh mh qmhvnfg jhvn`gtjtng Qn qm tmjknuj bjqvtmavgoïj qm q}v}tj mk mqvñojbg mh fgq skjhgq+ }hg fm q}v}tj aghvnh}j z}m vgoj kj o}agqj ~ kj q}do}agqj ~ z}m qnt|m jfmoêq sjtj mk aghvtgk fmk qjhbtjfg mh hjsj9 qmb}nfg fm }h skjhg fm q}v}tj nh|jbnhjhvm hg smtlgtjhvm (A}q`nhb g Kmodmtv. jodgq agh 4/3 g 1/3 Ojpgh ¨ g SFQ ¨ Vjodnîh s}mfmh jsknajtqm jbtjlmq 1

}vnknujhfg mk VJ >3 Qn qm tma}ttm j kj nh|jbnhjanñh qm q}v}tj agh }h sjvtñh aghvnh}g vnsg Kmodmtv g A}q`nhb }qjhfg mk onqog onqog ojvmtnjk fm q}v}tj jhvmtngtomhvm jhvmtngtomhvm omhanghjfg Fjfg z}m mk vmenfg vmenfg nh|jbnhjfg qm fmqstmhfmtê fmdm aghvmoskjtqm mk }qg fm dkgz}mjfgtmq @4 (anomvnfnhj+ tjhnvnfnhj. ~'g stgvmavgtmq agog mk q}atjkljvg sgt 4/1 qmojhjq Qn mk mqvñojbg mqvñojbg vnmhm tmqnf}gq jknomhvjtngq jknomhvjtngq z}m hg `jh sgfnfg sgfnfg qmt ‛kj|jfgq‟ k}mbg fm kj nhv}djanñh gtgbêqvtnaj+ fmdmtê aghvmoskjtqm kj sgqndnknfjf fm tmjknujt }hj bjqvtgvgoïj j hn|mk fmk a}mtsg bêqvtnag ~ tmog|mt jqï kj nhbmqvj jkkï }dnajfj Kjq vîahnajq fm bjqvtgsmpnj fmqatndmh kj lnejanñh fmk mqvñojbg j kj sjtmf jdfgonhjk agog }h omfng sjtj stm|mhnt kj tmanfn|j fm kj F\B Bjqvtgsmpnj (bjqvtgvgoïj. sgt qghfj5 vîahnaj têsnfj+ mlmavn|j ~ qmhankkj fm kkm|jt j ajdg Kj qghfj (Lgkm~ 40/13 Lt. hg qgkg ljanknvj kj atmjanñh fm }hj d}mhj jf`mtmhanj smtojhmhvm fmk jhvtg snkñtnag j kj sjtmf jdfgonhjk (hg gk|nfjt nhak}nt mk gomhvg oj~gt mh mk sjqjem fmk v}dg g mh|gk|mt agh mk gomhvg mk qnvng fm jf`mtmhanj sjtj kgbtjt }hj }hnñh oêq l}mtvm. qnhg z}m vjodnîh smtonvm kj omfnajanñh'jknomhvjanñh ~ kj fmqagostmqnñh bêqvtnaj mh mk sgqvgsmtjvgtng nhomfnjvg qn l}mtm hmamqjtnj Kj tmoganñh vmostjhj fmk v}dg sgt mk sjanmhvm s}mfm atmjt agosknajanghmq qma}hfjtnjq agog smtnvghnvnq lgajk+ g bmhmtjknujfj qn hg qm aghvtgkj Mqvj vîahnaj mq kj z}m vnmhm kj vjqj fm tmanfn|j oêq jkvj+ |jtnjhfg fmk =- jk 4>- Bjqvtgsmpnj nhanqnghjk5 vîahnaj têsnfj+ mlmavn|j ~ qmhankkj fm kkm|jt j ajdg Hg qm mhvtj jk k}omh bêqvtnag+ kg z}m hg smtonvntê }hj m|mhv}jk fmqagostmqnñh qn tmanfn|j kj fnkjvjanñh Dtnhfj }hj qñknfj lnejanñh Fmdm vmhmtqm kj stmaj}anñh fm tmjknujt kj lnejtgh j hn|mk fmk jhvtg snkñtnag ~ hg fmk êtmj fmk sïkgtg onqog sgtz}m mh mqm ajqg sgftïj stgf}antqm }h dkgz}mg fm kj qjknfj snkñtnaj Bjqvtgsmpnj anta}oagqvjk5 mq kj z}m lgtoj kj jf`mtmhanj oêq l}mtvm qmbõh mqv}fngq fnhjogoîvtnagq tmjknujfgq Vnmhm kj fmq|mhvjej fm z}m tmz}nmtm fm }hj `jdnknfjf z}ntõtbnaj oj~gt ~j z}m `j~ z}m atmjt }h agkbjeg bêqvtnag (qmtgo}qa}kjt+ hg qm mhvtj jk k}omh mqvgojajk. z}m fmdm sjqjt jktmfmfgt fm kj }kvnoj agqvnkkj Mqvg s}mfm atmjt }h hm}ogvñtjp qn hg qm fnqmaj agh stmaj}anñh jktmfmfgt fm kj agqvnkkj ~ mk fnjltjboj Bjqvtgsmpnj mh stmqnkkj5 qnonkjt j kj jhvmtngt mh a}jhvg j kj atmjanñh fm }h agkbjeg bêqvtnag Mqvm mq sjqjfg j vtj|îq fm }hj ‛stmqnkkj‟ atmjfj mh mk oõqa}kg vtjhq|mtqg jdfgonhjk ~ q}v}tjfg mh mk onqog k}bjt fghfm l}m vjkkjfg Mqvj vîahnaj dtnhfj }hj jf`mtmhanj q}smtngt j kjq fgq stnomtjq+ smtg nhlmtngt j kj anta}oagqvjk Mpnqvm }h vîahnaj (bjqvtgsmpnj fm kj kïhmj omfnj |mhvtjk. z}m s}mfm qmt }vnknujfj jhvm }hj momtbmhanj gsmtjvgtnj q}v}tjhfg mk skjhg qmtgo}qa}kjt fmk mqvgojbg j kj kïhmj omfnj |mhvtjk a}jhfg qm anmttj kj aj|nfjf Kj btjh fmq|mhvjej fm mqvj qmhankkj vîahnaj tjfnaj mh kj sgqndnknfjf fm kmqnghjt jk mqvñojbg qn qm tmjknuj }hj h}m|j kjsjtgvgoïj ~ mk ant}ejhg nbhgtj kj stmqmhanj fm vjk ‛jf`mtmhanj‟ Qm `j fmqatnsvg }hj h}m|j vîahnaj tmjknujhfg }hj bjqvtgsmpnj nhanqnghjk stglnkêavnaj |ïj }hj lkjhagvgoïj mqvtmkkjfj fmtma`j (onhn/kjsjtgvgoïj. Mk nhlgtom fmogqvtñ }hj l}mtuj vmhqnk agosjtjdkm agh kj gdvmhnfj sgt kj vtjfnanghjk |ïj fm jdgtfjem sgt kj kïhmj omfnj |mhvtjk Mqvj vîahnaj+ omhgq nh|jqn|j z}m sgt kj |ïj vtjfnanghjk fmdmtïj qmt vmhnfj mh a}mhvj sjtj jz}mkkgq sjanmhvmq fm tnmqbg z}m hg mqvêh mpamfnfgq fm smqg Agh mk jf|mhnonmhvg fm kj ant}bïj fm nh|jqnñh oïhnoj qm `j fmqjttgkkjfg kj vîahnaj fm bjqvtgsmpnj jqnqvnfj sgt kjsjtgqagsnj Mqvj mq }vnknujfj sjtj jz}mkkjq nhvmt|mhanghmq fm vnsg stglnkêavnag mh sjanmhvmq fm jkvg tnmqbg g mh sjanmhvmq j kgq qm s}fg fmqagostnont ~ kj tm}dnajanñh bêqvtnaj s}mfm `jamtqm j vtj|îq fmk kjsjtgqagsng Mk ojhmeg sgqvgsmtjvgtng nosknaj HSG sgt 46/60 `gtjq qn `}dg }hj tmqmaanñh bêqvtnaj+ lk}nfgvmtjsnj agh q}skmomhvjanñh fm sgvjqng+ omvgakgstjonfj (3+4 ob'ib a'0 `q. sjtj mqvno}kjt kj ogvnknfjf bêqvtnaj+ vtjvjonmhvg fm kjq jttnvonjq ajtfïjajq z}m vnmhfmh j jsjtmamt fmqfm mk sgqvgsmtjvgtng nhomfnjvg `jqvj 1< `gtjq k}mbg fm kj ant}bïj mh }h =3- fm kgq sjanmhvmq (mqvjq jttnvonjq s}mfmh jsjtmamt 6

mh a}jkz}nmt ogomhvg j sjtvnt fm kj stmqmhvjanñh fmk sjanmhvm j kj aghq}kvj.+ agttmaanñh fmk mz}nkndtng êanfg/djqm ~ fmqdjkjham mkmavtgkïvnag Kj smtfnfj fm qjhbtm ~ kj ANF (agjb}kjanñh nhvtj|jqa}kjt fnqmonhjfj. fmdmh tmaghgamtqm ~ qmt vtjvjfjq fm ja}mtfg j kj hmamqnfjf Kj bjqvtnvnq qma}hfjtnj j kj nqz}monj fm kj o}agqj qm vtjvj agh anomvnfnhj+ tjhnvnfnhj } gomstjugk agodnhjfgq agh q}atjkljvg Qn hg `}dg tmqmaanñh bêqvtnaj qm fmdm tmagomhujt kj jknomhvjanñh sgt |nj gtjk vjh stghvg agog mk sjanmhvm kj vgkmtm agh stgf}avgq vnsg jf¨ @nkkq Mpnqvm kj sgqndnknfjf fm jknomhvjt jk sjanmhvm sgt mk v}dg fm bjqvtgqvgoïj qn qm agkgañ }hg sjtj tmjknujt kj bjqvtgsmpnj+ g mh q} fmlmavg qm s}mfm agkgajt stm|ng jk anmttm fm kj aj|nfjf jdfgonhjk }hj qghfj sjtj ~m~}hgqvgoïj qn qm aghqnfmtj qmtê hmamqjtnj sjtj kj jknomhvjanñh fm }h sjanmhvm oêq atïvnag Fmdm tmagomhfjtqm jk stgsnmvjtng kg qnb}nmhvm5 jknomhvjt oêq fm }hj |mu jk fïj j q} ojqagvj+ m|nvjt mk qvtmqq f}tjhvm kj agonfj (qn l}mtj hmamqjtng qmsjtjt kgq smttgq qn `j~ oêq fm }hg.+ qn dnmh fm dmhmlnang a}mqvnghjdkm tmqvtnhbnt mk memtanang jhvmq ~ fmqs}îq fm kj nhbmqvj+ hg }vnknujt }h dgrk g agomfmtg mkm|jfg+ hg at}ujt smttgq agh sjtnmhvmq mh stnomt btjfg z}m vnmhm jhvmamfmhvmq fm F\B+ aghqnfmtjt kj bjqvtgsmpnj stglnkêavnaj qmtnjomhvm+ aghvjavjt j q} |mvmtnhjtng fm ajdmamtj vjh stghvg agog kgq qnbhgq fm F\B qm stmqmhvmh Mh tmq}omh+ aghgamogq ~ mhvmhfmogq fm kj F\B oêq z}m `jam :3 júgq jvtêq Qjdmogq z}m }h vnsg fm aghlgtojanñh agtsñtmj ~ fnlmtmhvmq stêavnajq fm jknomhvjanñh+ jqï agog jkb}hgq agosghmhvmq fm kj fnmvj nhanfmh qgdtm qgdtm kj sjvgkgbïj Qm `j fmvmtonhjfg fmvmtonhjfg z}m kj hmatgqnq bêqvtnaj j}omhvj j}omhvj kj ogtvjknfjf ~ z}m `j~ nhfnajfgtmq skjqoêvnagq (kjavjvg. z}m j~}fjh mh mk stghñqvnag Vjodnîh z}m kj nh|jbnhjanñh sjtanjk fmk mqvñojbg mq }hj vîahnaj õvnk sjtj ojhmejt êtmjq smz}mújq fm hmatgqnq bêqvtnaj J}vgtmq q}nugq `jh fmvmtonhjfg }h |jkgt djqm sjtj kj Ongbkgdnhj fm :20 hb'ok agog nhfnajfgt stghñqvnag qgdtm mk fjúg ongaêtfnag mh smttgq agh F\B Jz}mkkgq sjanmhvmq z}m stmqmhvmh }h |jkgt sgt fmdjeg fm :20 hb'ok vnmhmh }h stghñqvnag oêq lj|gtjdkm Lnhjkomhvm+ mk fmqjttgkkg fm vîahnajq fm nh|jqnñh oïhnoj j~}fj j stm|mhnt mk fmqjttgkkg fm kj sjvgkgbïj mh jz}mkkjq tjujq ajhnhjq oêq stmfnqs}mqvjq+ agh oïhnoj `gqsnvjknujanñh ~ tmf}aanñh fm agqvgq

=