42906177-Decja-hirugija

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Prof. dr Radoslav Aleksi Prof. dr Dragan okovi

DEJA HIRURGIJAza studente medicine

Medicinski fakultet Kragujevac

Autori:

Prof. dr Radoslav Aleksi Prof. dr Dragan okovi DEJA HIRURGIJA za studente medicineRecenzenti:

Prof. dr Dragia Raki Prof. dr Aleksandar GigiIzdava:

Medicinski fakultet, KragujevacZa izdavaa

Prof. dr Milorad JevtiLektor i korektor:

Prof. Duan DavidoviTehniko ureenje

Nikola Ili Branko ArsiPriprema za tampu i tampa:

PRIZMA, KragujevacTira:

500 primerakaPrvo izdanje 1999. godine ISBN: 86-82477-25-4

Prof. dr Radoslav Aleksi & Prof. dr Dragan okoviZabranjeno je fotokopiranje, prevoenje i pretampavanje bilo kojeg dela knjige bez prethodne pismene saglasnosti autora. Odlukom Komisije za izdavaku delatnost Medicinskog fakulteta Univerziteta u Kragujevcu, br. 517/99, rukopis je odobren za tampanje kao pomoni udbenik za hirurgiju.

Prof. dr Radoslav Aleksi Prof. dr Dragan okovi

DEJA HIRURGIJAZA STUDENTE MEDICINE

KRAGUJEVAC 1999.

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SADRAJ

PREDGOVOR ....................................................................................................... 9 Poglavlje I OPTI DEO (R. Aleksi) UVOD ............................................................................................................... 13 NEONATALNI PERIOD .......................................................................................... 14 OPTIMALNO VREME ZA OPERACIJU ........................................................................ 15 TUMORI KOD DECE ............................................................................................. 16 Benigni tumori ........................................................................................... 17 Maligni tumori ........................................................................................... 18 Poglavlje II GLAVA (R. Aleksi) RASCEPI PRIMARNOG I SEKUNDARNOG NEPCA (SCHISIS PALATI ANTERIOR S. PRIMUM; SCHISIS PALATI POSTERIOR S. SECUNDUM) ........................................... 25 Rascep primarnog nepca .............................................................................. 25 Rascep sekundarnog nepca ........................................................................... 26 Rascep primarnog i sekundarnog nepca .......................................................... 27 MACROSTOMA .................................................................................................... 28 NAZOMAKSILARNI RASCEP ................................................................................... 28 SREDNJI RASCEP GORNJE I DONJE USNE ................................................................ 28 PIERRE-ROBINOV SINDROM ................................................................................. 28 MACROGLOSIA ................................................................................................... 28 FRENULUM LINGUAE BREVIS ................................................................................ 29 Poglavlje III VRAT (R. Aleksi) LIMFADENOPATIJE ............................................................................................. 33 RAZVOJNI OSTACI .............................................................................................. 34 Medijalna cista vrata (cystis colli mediana) .................................................... 34 Lateralna cista i fistula vrata (cystis colli lateralis, fistula colli lateralis) ..................................................... 34

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Medijalni dermalni rascep ............................................................................ 35 CISTINI HIGROM VRATA (HYGROMA COLLI CYSTICUM) ............................................ 36 TIREOIDNE OTEKLINE ......................................................................................... 36 TORTIKOLIS (TORTICOLLIS, CAPUT OBSTIPUM, KRIV VRAT) ....................................... 37 Poglavlje IV GRUDNI KO (D. okovi) NEONATALNI MASTITIS ....................................................................................... 41 UROENE MANE ZIDA GRUDNOG KOA ................................................................... 42 Uroeni rascepi grudne kosti ........................................................................ 42 Depresioni deformiteti (pectus excavatum) (Uroene levkaste grudi, pectus infundibuliforme) .......................................... 42 Protruzioni deformiteti (pectus carinatum) ..................................................... 44 Uroene mane rebara i kljune kosti .............................................................. 45 UROENE MANE PLUA ....................................................................................... 46 Uroene ciste plua (cystis pulmonum congenita) ........................................... 46 Lobusni emfizem (emphysema lobaris) ........................................................... 48 Sekvestracija plua (sequestratio pulmonum) .................................................. 49 Medijastinalne bronhogene ciste (Cystis bronchogenes mediastinalis) .............................................................. 50 UROENE DIJAFRAGMALNE KILE ........................................................................... 50 Zadnje-bona dijafragmalna kila (Hernia diaphragmatica congenita - Bochdalek) .............................................. 51 Retrosternalna dijafragmalna kila (Hernia diaphragmatica retrosternalis congenita - Morgagni) ............................ 52 Eventracija (relaksacija) dijafragme ............................................................... 53 Dijafragmalne kile u predelu zjapa jednjaka (Hernia hiatus oesophagei) .............. 53 UROENE MANE JEDNJAKA .................................................................................. 54 Atrezija ezofagusa i traheoezofagusna fistula (atresio oesophagei cum fistulam tracheooesophagealis) .................................. 54 Gastroezofagusni refluks (Refluxio gastrooesophagealis) ................................... 56 Poglavlje V ABDOMEN (D. okovi) UROENE MANE PREDNJEG TRBUNOG ZIDA ........................................................... 61 Nepotpun razvoj prednjeg trbunog zida ........................................................ 61 Patologija pupka ........................................................................................ 63 Uroene mane preponskog predela ................................................................ 64 UROENE MANE TRBUNIH ORGANA ..................................................................... 66 Kongenitalni ileus (Ileus congenitalis, intestinalna opstrukcija novoroeneta ) ............................ 66 Morbus Hirschsprung (megacolon congenitalis, uroena aganglionoza creva, kongenitalni ili aganglionarni megakolon) ............................................ 70 Anorektalne anomalije ................................................................................. 72 HIPERTROFINA STENOZA PILORUSA (STENOSIS PYLORI HYPERTROPHICA) .................. 74 INVAGINACIJA CREVA (INVAGINATIO INTESTINALIS,INTUSSUSCEPTIO INTESTINALIS) ... 76

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SPECIFINOST APENDICITISA U DEJEM UZRASTU ................................................... 78 Poglavlje VI DEJA UROLOGIJA (D. okovi) UROENE MANE UROTRAKTA ................................................................................ 83 UOPTE O UROENIM MANAMA UROTRAKTA ........................................................... 83 POSEBNO ZNAAJNE UROENE MANE UROTRAKTA ................................................... 85 Uroene mane bubrega ............................................................................... 85 Kongenitalna hidronefroza (hydronephrosis congenita) ................................... 86 Kongenitalni megaureter (megaureter congenita) ........................................... 87 Vezikoureteralni refluks (refluxio vesicoureteralis) .......................................... 88 Ekstrofija mokrane beike (extrophio vesicae urinariae) ................................. 89 UROENE MANE SPOLJNIH POLNIH ORGANA ........................................................... 90 Fimoza (phimosis) ...................................................................................... 90 Hipospadija (hypospadias) ........................................................................... 92 Epispadija (epispadias) ............................................................................... 93 Nesputen testis (nondescensus testis, cryptorchismus, retentio testis, ectopio testis) ...................................................................... 94 Anorhija (anorchio) .................................................................................... 95 AKUTNI SKROTUM .............................................................................................. 95 Torzija testisa (torsio testis) ........................................................................ 96 Torzija ciste hidatide - Morgagni (torsio cystae hydatidae - Morgagni) ............... 97 Akutni orhiepididimitis (orchiepididymitis acuta) ............................................ 97 VARIKOKELA (VARICOCELE) ................................................................................. 97 NEUROGENA BEIKA (VESICA NEUROGENES) ........................................................... 98 ENUREZA (ENURESIS) ....................................................................................... 100 Poglavlje VII DEJA ORTOPEDIJA (R. Aleksi) OPTI DEO ...................................................................................................... 103 RAZVOJNI POREMEAJ KUKA (LUXATIO COXAE CONGENITA, DISLOCATIO COXAE, DYSPLASIO COXAE, UROENO IAENJE KUKA, LUKSANTNA MALFORMACIJA KUKA) .................................................................... 105 DRUGE ANOMALIJE I OBOLJENJA KUKA ...............................................................