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MALFORMACIONES CONGÉNITAS DIGESTIVAS EN EL RECIÉN NACIDO 2 DE JUNIO DE 2014

“AÑO DE LA PROMOCION DE LA INDUSTRIA RESPONSABLE Y EL COMPROMISO CLIMATICO”

UNIVERSIDAD SAN PEDRO TEMA

: MALFORMACIONES CONGÉNITAS DIGESTIVAS EN EL RECIEN NACIDO

FACULTAD

: CIENCIAS DE LA SALUD/ ENFERMERIA

DOCENTE

: LIC. CARMEN SILVA COLLANTES

CICLO

: VIII

INTE IN TEGR GRAN ANTE TES S : BEJAR RUIZ, RICARDO COLLAZO COSTILA, MARICELA

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DEDICATORIA

Este trabajo va dedicado a nuestros padres por todo su esfuerzo que hacen para que nosotros podamos lograr nuestras metas, también a nuestros compañeros para que juntos podamos aprender más del tema, y a nuestra Licenciada por todos sus conocimientos que nos brinda día con día

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MALFORMACIONES DIGESTIVAS EN EL RECIÉN NACIDO Un !"#$%!&'(n &$n)*n'+ ,- .n /,#,&+$ ,n " n+$! /," &.,%$ .!n$3 $ ,n ," #.n&'$n!',n+$ /, "$- (%)n$- $ -'-+,!- /," !'-!$3 ., -, !n'5,-+ /,-/, ," !$!,n+$ /," n&'!',n+$6 E-+ "+,%&'(n -, %$/.&, $%., .n ),n+, &$n&%,+$ &+7 -$8%, ," /,-%%$""$ /," ,!8%'(n ,n ," 9',n+%, !+,%n$6 S,)7n ,n .* !$!,n+$ /," /,-%%$""$ /," #,+$ &+7,3 ," /,#,&+$ #,&+%  .n (%)n$ . $+%$3 ; &$n /'#,%,n+, )%9,// ; %$n(-+'&$6

CAUSAS Y FACTORES DE RIESGO N$ ,- $-'8", -')n% .n &.- ,-,&5&  &,%& /, .n <0= /, "- n$!"&$n)*n'+-6 N$ $8-+n+,3 -, n '/,n+'5&/$ ").n- /, -.- &.-- $ #&+$%,- /, %',-)$6

Factor! !ociocon"#ico! A.n., .,/, +%+%-, /, .n /,+,%!'nn+, 'n/'%,&+$3 "- n$!"- &$n)*n'+- -$n !- #%,&.,n+,- ,n "- #!'"'- ; -,- &$n ,-&-$- %,&.%-$-6 S, &"&." ., %$>'!/!,n+, .n ?4= /, "$- /,#,&+$- /, n&'!',n+$ )%9,- -, %$/.&,n ,n -,- /, 'n)%,-$- 8@$- ; !,/'$-3 ,n "$- ., "- !/%,- -$n !- 9."n,%8",-  " !"n.+%'&'(n3 +n+$ $% !&%$n.+%',n+,- &$!$ $% !'&%$n.+%',n+,-3 ; .,/,n +,n,% !;$% ,>$-'&'(n  ),n+,- $ #&+$%,- ., 'n/.&,n $ .!,n+n " 'n&'/,n&' /, .n /,-%%$""$ %,n+" n$%!"3 ,n ,-,&'" ," "&$$" ; "- 'n#,&&'$n,-6 L ,// !+,%n 9n/ +!8'*n 'n&%,!,n+ ," %',-)$ /, ").n- "+,%&'$n,&%$!$-(!'&-3 &$!$ ," -n/%$!, /, D$n6

Factor! gn$tico!

L &$n-n).'n,'// .!,n+ " %,9",n&' /, n$!"- &$n)*n'+- ),n*+'&%%- ; !."+'"'& $% &,%& /, /$- ," %',-)$ /, !.,%+, n,$n+" , 'n#n+'"3 /'-&&'// 'n+,",&+." ; n$!"- &$n)*n'+- )%9,- ,n "$- !+%'!$n'$- ,n+%, %'!$- ,%!n$-6 A").n- &$!.n'//,- *+n'&-3 &$!$ "$- @./$- -.,n,- $ "$5n"n/,-,-3 +',n,n .n !;$% %,9",n&' /, !.+&'$n,- ),n*+'&- %%- ., &$n/'&'$nn .n !;$% %',-)$ /, n$!"- &$n)*n'+-6

E!ta%o n&triciona' % 'a #a%r

L- &%,n&'- /, ;$/$ ; #$"+$3 ," -$8%,,-$ ; ,n#,%!,//,- &$!$ " /'8,+,!,""'+.- ,-+n %,"&'$n/- &$n ").n- n$!"- &$n)*n'+-6 P$% ,@,!"$3 " &%,n&' /, #$"+$ .!,n+ ," %',-)$ /, +,n,% n'$- &$n /,#,&+$- /," +.8$ n,.%" 6

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Factor! a#)inta'! L ,>$-'&'(n !+,%n  ,-+'&'/-3 #%!&$- ; /%$)-3 "&$$"3 +8&$3 %$/.&+$.!'&$-3 "+- /$-'- /, 9'+!'n A " 'n'&'$ /," ,!8%$ ; "+- /$-'- /, %/'&'(n .!,n+n ," %',-)$ /, ., "$- n'$- n&n &$n n$!"- &$n)*n'+-6 E" ,&$ /, +%8@% ,n 8-.%,%$-3 #.n/'&'$n,- $ !'n- $ /, 9'9'% &,%& /, ,-$- ".)%,- +!8'*n .,/, -,% .n #&+$% /, %',-)$6

ATRESIA ESOF*GICA E- .n +%-+$%n$ &$n)*n'+$ /," %+$ /'),-+'9$3 ,n ," &." ," ,-(#)$ n$ -, /,-%%$"" %$'/!,n+, ; n$ ,-+ &$n,&+/$ ,-+(!)$6 S$"$ +,%!'n ,n .n 8$"-3 /, !$/$

&$n .,

,"

n/ /, "$ ., ," 8,8* +%) 'n)%,- ,n ," ,-+(!)$6 E" ,-(#)$ ,- ," +.8$ .,

n$%!"!,n+, "",9 ," "'!,n+$ /,-/, " 8$& ,-+(!)$6

-+ ,"

En " !;$% %+, /, "$- &-$- -, "$)% .n &$n,>'(n &$!.n'&n+, $ #-+." ,n+%, .n$ /, "$- -,)!,n+$/," ,-(#)$ ; " +%.,6 A !,n./$ "$- %,&'*n n&'/$&$n +%,-' ,-$#)'& +!8'*n n&,n &$n $+%$+%-+$%n$- &$n)*n'+$- /," +.8$ /'),-+'9$3 /," &$%(n ; $+%$- (%)n$-3  !,n./$ n$ &$!+'8",- &$n " 9'/6

ETIOLOGIA S, +%'8.;,  .n "+,%&'(n ,n " !')%&'(n /, "$- "',).,- "+,%",- $ /,+,n&'(n /," &%,&'!',n+$ /.%n+, " ,9)'n&'(n   ;   -,!6 D, ),-+&'(n6

EPIDEMIOLOGIA L +%,-' ,-$#)'& ,- .n +$"$) %,"+'9!,n+, #%,&.,n+,3 $&.%%, ,n %$>'!/!,n+, 1 $% &/ 300043<00 n&'/$- 9'9$-6 A"%,/,/$% /, .n +,%&,% %+, /, "$- n'$- #,&+/$- ,- %,!+.%$6 En !- /," H<= /, "$- &-$-3 " +%,-' ,-$#)'& -, -$&'  .n +,!t&'a tra-&o. !o+ágica In+,%n&'$n"!,n+,3 " #%,&.,n&' %,)'-+%/ !- ,",9/ -, ,n&.,n+% ,n F'n"n/' &$n 1:2<00 n&'/$- 9'9$-6 M- #%,&.,n+,- ,n 9%$n,-6

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MALFORMACIONES CONGÉNITAS DIGESTIVAS EN EL RECIÉN NACIDO 2 DE JUNIO DE 2014 L +%,-' ,-$#)'& -, &"-'5& ,n < +'$-:

tio I +%,-' -'n #-+." H= /, "$- &-$-6 tio II &$n #-+." ,n " %+, -.,%'$% $ %$>'!" 1= /, "$- &-$-6 tio III &$n #-+." ,n " %+, 'n#,%'$% $ /'-+" H<= /, "$- &-$-K -.,",n ,-+% &,%& ," .n$ /," $+%$6 tio IV &$n #-+." ,n !8- %+,- 1= tio V &$n #-+." ,n #$%! /, H ; -'n +%,-'3 ,n &.;$ &-$ n$ -, +%+ /, .n 9,%//,% +%,-'3 .n., -, 'n&".;, &$!$ +" ,n " &"-'5&&'(n <=6

FISIOPATOLOG3A S, /,8,  .n /,#,&+$ /," %$&,-$ /, +8'&&'(n ., /'9'/, " ,-(#)$ ;  " +%., ,n .n &$%/(n ,'+,"'" /, &%,&'!',n+$ 'n+,%n$6 L- %,- /, ,-+%,&!',n+$ "+,%",- /," ,-(#)$ #$%!n .n +8'., ,n+%, " +%., ; ," ,-(#)$ ; ., /, !n,% n(!" .,/, )'%%" ,n -,n+'/$ /$%-"3 %,-."+n/$ " +%,-' ,-$#)'&6 D 1? /, " ),-+&'(n6 L 'n+,%%.&'(n . $&".-'(n /," ,-(#)$ '!,/'% " /,)".&'(n /," ".'/$ !n'(+'&$3 "$ ., -, ,>%,-% &$n $"''/%!n'$-6

CAUSAS S, /,8,  " /,-9'&'(n /," +8'., +%.,$ ,-$#)'&$ ,n .n /'%,&&'(n $-+,%'$% &$!$ &$n-,&.,n&' /, "$ &." ,>'-+, .n -,%&'(n 'n&$!",+ /," ,-(#)$ ; ," +.8$ "%'n)$+%.,"6 Un #,+$ &$n +%,-' ,-$#)'& ,- 'n& /, /,)".+'% ".'/$ !n'(+'&$K $% &$n-').',n+,3 ,-+, ".'/$ n$ .,/, -% " 'n+,-+'n$ % -. 8-$%&'(n ; +%n-$%+,  +%9*- /, " "&,n+  " -n)%, !+,%n % -. ,"'!'n&'(n6 E-+$ &$!$%+ " %'&'(n /, o'i4i%ra#nio!5 " &.!."&'(n /, .n &n+'// ,>&,-'9 /, ".'/$ !n'(+'&$6 L$- %,&'*n n&'/$- .,@/$- /, +%,-' ,-$#)'& -.,",n +,n,% .n -,&+$ -n$ ; -.- %'!,%- /,)".&'$n,- -$n n$%!",-6 D, %,,n+,3 ," ".'/$ %,)%,-  +%9*- /, " n%' ; /, " 8$& ; -, %$/.&, 'n-.5&',n&' %,-'%+$%'6

SIGNOS Y S3NTOMAS C$"$%&'(n ."/ /, " '," &'n$-'- &$n ," 'n+,n+$ /, "'!,n+&'(n6 T$-3 n.-,- ; -5>' &$n ," 'n+,n+$ /, "'!,n+&'(n6 B8,$6

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MALFORMACIONES CONGÉNITAS DIGESTIVAS EN EL RECIÉN NACIDO 2 DE JUNIO DE 2014 A"'!,n+&'(n /,5&',n+,6

FACTORES DE RIESGO Casos en hermanos e hijos de padres con atresia esofágica No existe un patrón hereditario.> frecuencia en gemelos.

COMPLICACIONES P%$8",! /, "'!,n+&'(n6 R,.@$6 E-+%,&!',n+$6 N,.!$n6 S"'9&'(n 8.n/n+, ; ,-.!$-6 D'5&."+/ "'!,n+'&'6 M.,%+,6

DIAGN/STICO E" /')n(-+'&$ /, .n +%,-' /, ,-(#)$ $&.%%, &-' -',!%, $-n+" &$n " -$-,& ,n &-$ /, $"''/%!n'$- $ ,n &-$- ,n /$n/, " !n'$8% /, 'n-,%&'(n /, " -$n/ n-$)-+%'& . $%$)-+%'& /," %,&'*n n&'/$ ,n " -" /, %+$- n$ -.,% "$- 10 &! /,-/, " %&/ /,n+%' -+ ," &%/'- ,-+$!&"6 D, n$ &,%-, ,-+ !n'$8% " %,&'*n n&'/$3 -, $8-,%9% !- +%/, ., ," 8,8* %,-,n+ ',%-"'9&'(n3 /+$ ., $n, ,n -$-,& .n %$88", ,-(#)$  #$n/$ &',)$ ., n$ ,%!'+, ., " -"'9 -, " ,-+(!)$6 Un %/'$)%# /, +(%> ; 8/$!,n &$n &$n+%-+, %,9," /, 'n!,/'+$ " %,-,n&' /," -&$ ,-$#)'&$6

TRATAMIENTO

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PRONOSTICO L ,%n' /," /'#%)! $% - !'-! n$ +',n, .n ,#,&+$ /9,%-$K ," %$n(-+'&$ /,,n/, /, " '$"-' ."!$n%3 " ',%+,n-'(n ."!$n% ; " /,5&',n&' /, -.%#&+n+,6 P% .,""$- 8,8*- ., +',n,n DC ," %$n(-+'&$  !,@$%/$ ,n " &+."'// )%&'-  "$- /,"n+$- ,n ," &.'//$ 'n!,/'+$ ; ,n " &'%.) %,%/$%6 P% .,""$- 'n#n+,- ., #.,%$n /')n$-+'&/$- ,n ," 7+,%$3 ," %$!,/'$ /, -$8%,9'9,n&' ,- ,n " &+."'// /," H0= )%&'-  .n &.'//$ (+'!$6 E" /')n(-+'&$ %,n+" -')n'5& ., -, ,-,% ,-+, %$8",! $% "$ ., -, "n, ," %+$ ,n .n $-'+" ., .,/, $#%,&,% &.'//$- ,-,&'"'/$- ., 'n&".;,n ECMO6 T$/$ ,-+$ !,@$% ," %$n(-+'&$6 En ),n,%"3 "$- 8,8*- ., +',n,n .n %$n(-+'&$ ,$% -$n .,""$- ., +',n,n ," ,-+(!)$ ,%n'/$ &' ," +(%> ; ., -.- !/%,- %,-,n+%$n $"''/%!n'$- ,>&,-$ /, ".'/$ !n'(+'&$ /.%n+, ," ,!8%$6 L %,-,n&' /, !"#$%!&'$n,- -$&'/- ,- .n #&+$% n$ #9$%8", % ," %$n(-+'&$ ; -, &$n-'/,% ., "- ,%n'- 8'"+,%",- -$n3 ),n,%"!,n+,3 #+",-6 L -$8%,9'9,n&' ),n,%" ,- /," <0= ,%$ 9  /,,n/,% /, &/ 'n-+'+.&'(n ; /, "&'%&.n-+n&'- %+'&."%,- /, &/ 8,8* #,&+/$6 Un !" %$n(-+'&$ ,-+ -$&'/$  .n

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MALFORMACIONES CONGÉNITAS DIGESTIVAS EN EL RECIÉN NACIDO 2 DE JUNIO DE 2014 /')n(-+'&$ +,!%n$ /.%n+, ," ,!8%$ ; &$n n&'!',n+$ %,!+.%$ !,n$% /, "- 4 -,!n- /, 9'/6

ONFALOCELE E- .n /,#,&+$ &$n)*n'+$ ,n ," &." -, %,-,n+ %$+%.-'(n /, "$- 'n+,-+'n$- . $+%$- (%)n$8/$!'n",- /," 8,8*  +%9*- /," $!8"')$6 En "$&$n .n $n#"$&,",3 "$- 'n+,-+'n$- -("$ ,-+n &.8',%+$& /, +,@'/$ /,")/ E-+, /,#,&+$ /, " %,/ -, ," &,n+%$ $% "$ ., &$'n&'/, &$n " ,n+%/ /," &$%/(n ; -, .,/,n $8-,%9% #&'"!,n+,.

8,8*$% .n -'+7 ,n .!8'"'&"

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Página 1(


ETIOLOGIA !

N$ -, &$n$&, &+."!,n+, " &.-6

EPIDEMIOLOGIA !

Un $n#"$&,", /, +'$ ,.,$ &$n -("$ .n ,., $%&'(n /," 'n+,-+'n$ ., %$+%.;, /," 8/$!,n -, %,-,n+ ,n .n$ /, &/ <000 n&'/$- 9'9$-6

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En &!8'$3 .n$ /, +'$ )%n/, ,- /,&'%3 "$- 'n+,-+'n$-3 ," )/$ ; /,!(%)n$- %$+%.;,n /," 8/$!,n -, %,-,n+ ,n .n$ /, &/ 1060006

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E" $n#"$&,", #,&+ !- n'$- ., n'-6

TIPOS On+ac' -&o C$n+',n, -$"$ 'n+,-+'n$ ; n$ ; &$!%$!'-$ /," )/$3 ," 8,8* .,/, n&,% $% %+$ 9)'n"6 D,-.*- /," n&'!',n+$3 "$- (%)n$- ,>.,-+$- -, %,.8'&n ,n " &9'// 8/$!'n" ; ," $n#"$&,", -, &',%% .'%7%)'&!,n+,6 E-+$ -, /,n$!'n %,%&'(n %'!%'

On+ac' gran% C$n+',n, )/$ ; 8$- -, %,.',%, .n %+$ $% &,-%, % ,9'+% " %.+.% /, " !,!8%n ; ," +%.!+'-!$ /," )/$6 D,-.*- /," %+$3 "$- (%)n$- ,>.,-+$- -, &.8%,n &$n .n ,n9$"+$%'$ %$+,&+$% ; )%/."!,n+, %,'n)%,-n ,n " &9'// 8/$!'n" &$n " ;./ /, " )%9,//3 "$ ., $&.%%,  "$ "%)$ /, 9%'$- /-6 Un 9, ., "$(%)n$- n %,'n)%,-/$ ,n " &9'// 8/$!'n"3 -, &',%% .'%7%)'&!,n+, ," $n#"$&,",6

FISIOPATOLOGIA S, ',n- ., -, /,8,  &$n-,&.,n&' /, .n #"" ,n ," %,+$%n$ /," 'n+,-+'n$  " &9'// 10 12-,!n-3 /, ),-+&'(n6 P$% "$ ., /.%n+, ,-+, ,%'$/$3 ," &$n+,n'/$ 'n+,-+'n" .,/ #.,% /, ,""3 &.8',%+$ $% ," ,%'+$n,$ ; " !,!8%n !n'(+'&3 .,/n/$ ," &$%/(n .!8'"'&" 'n-,%+$ ,n ,-+, -&$ ., &.8%, ," /,#,&+$

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MALFORMACIONES CONGÉNITAS DIGESTIVAS EN EL RECIÉN NACIDO 2 DE JUNIO DE 2014 -+ .n 0= -, 9  %$/.&'% .n 8$%+$ $ !.,%+, 'n+%.+,%'n6 T',n,n .n %',-)$ .!,n+/$ /, RCIU3 $"''/%!n'$-3 %+$ %,!+.%$3 '$"-' ."!$n% ; !.,%+, n,$n+"6

CAUSAS !

E" $n#"$&,", $&.%%, /.%n+, ," /,-%%$""$ /," #,+$6 L$- 'n+,-+'n$- /," 8,8* n$%!"!,n+, %$+%.;,n ,n ," &$%/(n .!8'"'&" ,n ")7n !$!,n+$ /," /,-%%$""$6 En " !;$% /, "$- 8,8*-3 "$- 'n+,-+'n$- %,)%,-n " 8/$!,n  !,/'/ ., ," 8,8* &%,&,6 E" &$%/(n .!8'"'&" -, &',%% ; #$%! ," $!8"')$6

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E" $n#"$&,", -, %$/.&, &.n/$ "$- 'n+,-+'n$- n$ %,+$%nn " 8/$!,n6 E" 8/$!,n n$ -, .,/, &,%%% % #$%!% ," $!8"')$6

S3NTOMAS S, .,/, 9,% &"%!,n+,3 //$ ., "$- &$n+,n'/$- 8/$!'n",- -$8%,-",n $ %$+%.;,n  +%9*- /," %, /," $!8"')$

FACTORES DE RIESGO !

T8.'-!$ /.%n+, ," ,!8%$: ," %',-)$ ,- !;$% -' -, #.! !- /, .n .,+, $% /6

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C$n-.!$ /, "&$$" /.%n+, ," ,!8%$6

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U-$ /, !,/'&!,n+$- % ," -! n+,- /," %'!,% +%'!,-+%, /," ,!8%$ ; /.%n+, /'&$ +%'!,-+%,

!

S$8%,,-$ . $8,-'// ,n " !/%, n+,- /," ,!8%$6

COMPLICACIONES 

M.,%+, /, +,@'/$ 'n+,-+'n"6

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DIAGN/STICO

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MALFORMACIONES CONGÉNITAS DIGESTIVAS EN EL RECIÉN NACIDO 2 DE JUNIO DE 2014 •

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E" $n#"$&,", -.,", /,+,&+%-, &$n .n ,&$)%# #,+" /.%n+, ," -,).n/$ ; +,%&,% +%'!,-+%, /, ),-+&'(n6 T!8'*n .,/, %,"'%-, .n ,&$&%/'$)%! #,+" ,&$)%# /," &$%(n % 9,%'5&% " ,>'-+,n&' /, n$!"- &%/&-6 D,-.*- /," n&'!',n+$3 ," !*/'&$ .,/, /,+,&+% ," $n#"$&,", !,/'n+, ," ,>!,n #-'&$6 T!8'*n -, .,/, +$!% .n %/'$)%# ,>!,n /, /')n(-+'&$ ., .+'"' %;$- /, ,n,%) ,",&+%$!)n*+'& 'n9'-'8", % $8+,n,% '!),n,- /, "$- +,@'/$-3 "$- .,-$- ; "$- (%)n$- 'n+,%n$- ,n .n "& %/'$)%5& /,-.*/," n&'!',n+$ % ,9".% "- n$!"- /, $+%$- (%)n$- $ %+,- /," &.,%$6

TRATAMIENTO S' ," $n#"$&,", ,- ,.,$ -$"$ %+, /," 'n+,-+'n$ #.,% /," 8/$!,n3 $% "$ ),n,%" -, &$%%'), &$n &'%.) $&$ /,-.*- /," n&'!',n+$ % &$"$&% ," 'n+,-+'n$ ,n -. ".)% ; &,%%% " 8,%+.%6 S' ," $n#"$&,", ,- )%n/, !.&$- (%)n$- #.,% /," 8/$!,n3 " &'%.) &$%%,&+'9 -, &, $% ,+-6 L$- (%)n$- ,>.,-+$- -, .,/,n &.8%'% &$n .n !+,%'" ,-,&'" , 'n+%$/.&'%-, $&$  $&$ ,n ," 8/$!,n6 D,-.*- /, ., +$/$- "$- (%)n$- n -'/$ .,-+$- ,n -. ".)%3 -, &',%% " 8,%+.%

PRONOSTICO L !;$% /, "- 9,&,-3 " &'%.) .,/, &$%%,)'% ," $n#"$&,",6 E" %$n(-+'&$ /," 8,8* /,,n/, /, &.n+$ /$ $ *%/'/ /, 'n+,-+'n$ -, %,-,n+( ; -' -. '@$ +',n, $+%$/,#,&+$- &$n)*n'+$-6 A").n$- 8,8*- +',n,n %,.@$ )-+%$,-$#)'&$ /,-.*- /, " &'%.)6 E-+ #,&&'(n %$9$& ., ," "'!,n+$ $ ," &'/$ )-+%'&$ -, /,9.,"9n /,-/, ," ,-+(!)$ &' ," ,-(#)$6 A").n$- 8,8*- &$n $n#"$&,",- )%n/,- +!8'*n .,/,n +,n,% ."!$n,- ,.,$- ; $-'8",!,n+, n,&,-'+,n ," .-$ /, .n %,-'%/$%6

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=I=LIO ATRESIA ESOFAGICA 4ttBB9c&r%9c&Bin%94BAtr!ia!o+ C(A1gicaPr&)a!H9C(9A1#n! 4tt!BB!it!9goog'9co#B!itB'aarato+aringoBaarato.%ig!tio 4ttBB9%on219orgB)nBin%94J otionKco#contntiKartic'i%K::0a'tracion!.%ig!tia!. cati%K120a'i#ntacionIt#i%K21(0

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