SlideShare a Scribd company logo
Drenajul peritoneal continuu in
ascita refractara
Alexandru Andritoiu, MD
Dept. Medicina Interna
www.smucraiova.ro
De evitat arterele epigastriceDe evitat arterele epigastrice
inferioareinferioare!!
ParacenteParacentezaza
• Repeated large-volume paracentesis (4-6 L/day)
• Total paracentesis (single-day hospitalization
regime)
Postparacentesis circulatory dysfunction is not spontaneously reversible
and is associated with a shorter time to first readmission and shorter
survival.
Postparacentesis circulatory dysfunction was defined as an increase in
plasma renin activity on the sixth day after paracentesis of more than
50% of the pretreatment value to a level > 4 ng.mL-1.h-1.
Albumin is the best plasma expander to prevent this complication
Plasma expanders: Haemaccell, Dextran 70
CCateterateterele tunelateele tunelate
CateterCateter TenckhoffTenckhoff
Kit de drenajKit de drenaj PleurXPleurX
Placement of a permanent, tunnelled peritoneal drainage catheter (PleurX) for refractory malignant and portal-
hypertensive ascites in a multicentre study
G.-M. Semadeni GM et al, J Hepatology 2015 62 S381
Kit de drenajKit de drenaj AspiraAspira
Kit de drenaj ASEPT
Sistemul de drenaj ASEPT:
cateter drenaj ASEPT™
seringa 10cc
ac de insertie cu fir de ghidare 18G
fir de ghidare in forma de J
introducator de extragere
tunelar
adaptor linie drenaj 5 in 1
linie drenaj ASEPT™ cu capac
suport cateter din spuma
tampoane tifon 4”x4” (10 cm x 10 cm)
280 RON
1.190 RON
Cateter Pigtail
• Pac. 69 ani
• ICC cls IV-CMD
• Ascita cardiaca
• Cateter peritoneal
permanent (PleurX)
• Drenaj la domiciliu 2-4 L
ascita/sapt.
Durata drenajuluiDurata drenajului
• 500-1000 mL/h
• 3-4 h/zi
No drainageNo drainage:
La ce te poti astepta…
Blocaj – spala cateterul cu jet de solutie
salina sterila
Kinking-ul tubului de dren
Drenul a iesit din cavitatea
peritoneala – inlocuiste-l cu altul nou
intr-un alt loc
Caz clinic 1Caz clinic 1
• MM.. MMarianarian,, 47 ani
• Diagnostic:Diagnostic:
• Ciroza hepatica etanolica
• Ascita voluminoasa (grad 3)
• Drenaj continuu peritoneal (Seldinger)
cateter venos central
Analize laboratorAnalize laborator
TQ 19s
AP 45%
INR 1.39
Tb 86.000 mmc
US AbdominalaUS Abdominala
Ghidaj ecograficGhidaj ecografic
Anestezie locala 10 mL Xilina 1%
Insertia firului ghidInsertia firului ghid
Insertie dilatatator pe firul ghidInsertie dilatatator pe firul ghid
Insertie cateter pe firul ghidInsertie cateter pe firul ghid
Control USControl US
Imediat/post-procedura Ziua a 3-a
CT AbdomenCT Abdomen
F
A
A-ascita, F-ficat
Sageta-dren intraperitoneal
TratamentTratament
• Diuretic (Spiroloactona 50 mg/z+Furosemid 40
mg/z)
• Albumina (i.v.)
• Hepatoprotectie (Aspatofor, Arginina)
• AB (Sulcef 2g/z i.v.+ Ciprofloxacin 500mg x2/z)
• Drenaj continuu 7 zile (11.000 mL)
Curba greutatiiCurba greutatii
65
70
75
80
85
90
95
z 1 z 2 z 3 z 4 z 5 z 6 z 7 z 8 z 9 z 10 z 11 z 12 z 13
G (kg)
Drenaj continuu 7 zile
Caz clinic 2Caz clinic 2
P. Florea, 58 ani
• Diagnostic:Diagnostic:
• Ciroza hepatica vir. B+Alcool
• Ascita refractara
• Scor MELT: 19
Istoric
• 2012-colectectomie icter mecanic litiazic
• Ciroza hepatica VHB
• Biopsie hepatica intra-oper (Sp. CFR-Cva)
• 1 luna post-oper-decomp. ascitica
• Repetate spitalizari (ascita recurenta)
• Ian-Febr. 2014: Spit. Calafat (ascita
refractara: Spirono 6 cp, Furosemid 2 cp/z)-
fara rezultat!
Ex. clinicEx. clinic
• Abdomen destins, in tensiune
• Ascita abundenta
• Circulatie colaterala P/C
Ex. biologiceEx. biologice
• Tb 167.000/mmc
• TQ 22 s;
• AP 36%;
• INR 1.6
Cateter drenaj ascita (z 3)Cateter drenaj ascita (z 3)
Monitorizare functii vitaleMonitorizare functii vitale
Diureza < 1000 mL/zi
Drenaj 3500 mLDrenaj 3500 mL
Cefort 1g in PEV–Glucoza 5% 500 mL
PEV Dextran 70-glucoza 500 mL
Curba greutatii (Kg)Curba greutatii (Kg)
83 83 83
78
80 80
77.5
76
75 74.5
73 73 73 73 72.5
70
60
65
70
75
80
85
z 1 z 2 z 3 z 4 z 5 z 6 z 7 z 8 z 9 z 10 z 11 z 12 z 13 z 14 z 15 z 16
G (Kg)
Cateter peritoneal
Drenaj 1000 3500 3500 3500 4000 1800 1100 1700 1500 1500 2000 1500 1000 1500
Na 125 mmol/L Na 110 mmol/L
K 5.24 mmol/LK 5.98 mmol/L
Uree 53 mg/dL
Creatinina 0.9 mg/dL
Uree 90 mg/dL
Creatinina 1.46 mg/dL
Uree 85 mg/dL
Creatinina 1.2 mg/dL
TratamentTratament
• Albumina
• Aspatofort iv, Arginina, Liv 52, Silimarina
• Furosemid (1/2 f im), Spironolactona 25 mg x2
• Ampicilina 2 x 1 g – PEV, Ciprofloxacina 500
mg x 2, Normix 2 x 2 cp/z
• Sol. Dextran 70 (glucoza), Sol. Ringer,
• Pantoprazol 2x20 mg/z
• Fitomenadion 2x 1f i.m.
• Aspavim
Case clinic 3
P. Gheorghe, 54 ani
• Ciroza hepatica vir B –Ascita refractara
• Icter
• Tum hep. centrohilara (Colangiocarcinom)
• VSH 52 mm/h
• Tb 74.000/mmc
• INR 1.34
• BRT 7.5 mg/dL
• CA 19-9 58u/mL (N<35)
US-Abdomen
Ficat cirotic
Ascita
Tumora centro-hilara
Dilatatii CBIH
RMN Abdomen
• macronodul tumoral centro-hilar si in segm.
IV-VIII, in hipersemnal T2, hiposemnal T1,
heterogen postcontrast de 6/5 cm - ce
determina obstructia cailor biliare
intrahepatice
Drenaj ascita
Colangiografie percutana
Drenaj bilar extern-percutan
Z-4: angiocolita, sepsis, MSOF, exitus (Acynetobacter)
ComplicatiiComplicatii
ConcluziiConcluzii
• Drenajul percutan continuu al ascitei
refractare in CH poate fi o solutie
terapeutica (…costisitoare!)
• Atentie la:
• aspectul ascitei in zilele urmatoare
• riscul de infectie, in ciuda protectiei cu AB
• monitorizarea ionogramei serice si TA

More Related Content

What's hot

Timing of repair in Bile Duct Injury
Timing of repair in Bile Duct InjuryTiming of repair in Bile Duct Injury
Timing of repair in Bile Duct Injury
Dr Amit Dangi
 
Crohn's Disease by Dr Harsh Shah, Kaizen Hospital, Ahmedabad, India
Crohn's Disease by Dr Harsh Shah, Kaizen Hospital, Ahmedabad, IndiaCrohn's Disease by Dr Harsh Shah, Kaizen Hospital, Ahmedabad, India
Crohn's Disease by Dr Harsh Shah, Kaizen Hospital, Ahmedabad, India
Dr Harsh Shah
 
Lymphadenectomy in carcinoma stomach (2)
Lymphadenectomy in carcinoma stomach (2)Lymphadenectomy in carcinoma stomach (2)
Lymphadenectomy in carcinoma stomach (2)
Stalinsurgeon Joseph Antonymuthu
 
Complications after-pancreaticoduodenectomy-1228906772887050-1
Complications after-pancreaticoduodenectomy-1228906772887050-1Complications after-pancreaticoduodenectomy-1228906772887050-1
Complications after-pancreaticoduodenectomy-1228906772887050-1
Vanessa Alejandra Rubi Matute
 
The role of laparoscopy in acute care surgery
The role of laparoscopy in acute care surgeryThe role of laparoscopy in acute care surgery
The role of laparoscopy in acute care surgery
htyanar
 
Esophagus review 1 Nir Hus MD., PhD.
Esophagus review 1  Nir Hus MD., PhD.Esophagus review 1  Nir Hus MD., PhD.
Esophagus review 1 Nir Hus MD., PhD.
Nir Hus MD, PhD, FACS
 
Gall bladder carcinoma.04
Gall bladder carcinoma.04Gall bladder carcinoma.04
Gall bladder carcinoma.04
Dr. ZAHID IQBAL MIR
 
Vce
VceVce
Innovative Surgical Techiniques in Hepatobiliary and Pancreatic Surgery
Innovative Surgical Techiniques in Hepatobiliary and Pancreatic SurgeryInnovative Surgical Techiniques in Hepatobiliary and Pancreatic Surgery
Innovative Surgical Techiniques in Hepatobiliary and Pancreatic Surgery
ISWANTO SUCANDY, M.D, F.A.C.S
 
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAP
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAPCOMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAP
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAP
Dr Amit Dangi
 
Clinical Outcomes Of Complicated Diverticulitis Managed Nonoperatively
Clinical Outcomes Of Complicated Diverticulitis Managed NonoperativelyClinical Outcomes Of Complicated Diverticulitis Managed Nonoperatively
Clinical Outcomes Of Complicated Diverticulitis Managed Nonoperatively
Saeed Al-Shomimi
 
Ca esophagus
Ca esophagusCa esophagus
Ca esophagus
Shankar Zanwar
 
Endoscopy in obesity
Endoscopy in obesityEndoscopy in obesity
Endoscopy in obesity
Shankar Zanwar
 
Post operative crohn’s disease
Post operative crohn’s diseasePost operative crohn’s disease
Post operative crohn’s disease
Shankar Zanwar
 
Acute massive gastric dilatation a surgical emergency
Acute massive gastric dilatation   a surgical emergencyAcute massive gastric dilatation   a surgical emergency
Acute massive gastric dilatation a surgical emergency
Clinical Surgery Research Communications
 
Bdi
Bdi Bdi
Evaluating Current Laparoscopic Applications In Surgery
Evaluating Current Laparoscopic Applications In SurgeryEvaluating Current Laparoscopic Applications In Surgery
Evaluating Current Laparoscopic Applications In Surgery
George S. Ferzli
 
Management of metastatic lymph nodes in gastric cancer
Management of metastatic lymph nodes in gastric cancerManagement of metastatic lymph nodes in gastric cancer
Management of metastatic lymph nodes in gastric cancer
Dr. Haytham Fayed
 
New ca stomach mx sneha
New ca stomach mx snehaNew ca stomach mx sneha
New ca stomach mx sneha
Sneha George
 
D2 gastrectomy
D2 gastrectomyD2 gastrectomy
D2 gastrectomy
Deep Goel
 

What's hot (20)

Timing of repair in Bile Duct Injury
Timing of repair in Bile Duct InjuryTiming of repair in Bile Duct Injury
Timing of repair in Bile Duct Injury
 
Crohn's Disease by Dr Harsh Shah, Kaizen Hospital, Ahmedabad, India
Crohn's Disease by Dr Harsh Shah, Kaizen Hospital, Ahmedabad, IndiaCrohn's Disease by Dr Harsh Shah, Kaizen Hospital, Ahmedabad, India
Crohn's Disease by Dr Harsh Shah, Kaizen Hospital, Ahmedabad, India
 
Lymphadenectomy in carcinoma stomach (2)
Lymphadenectomy in carcinoma stomach (2)Lymphadenectomy in carcinoma stomach (2)
Lymphadenectomy in carcinoma stomach (2)
 
Complications after-pancreaticoduodenectomy-1228906772887050-1
Complications after-pancreaticoduodenectomy-1228906772887050-1Complications after-pancreaticoduodenectomy-1228906772887050-1
Complications after-pancreaticoduodenectomy-1228906772887050-1
 
The role of laparoscopy in acute care surgery
The role of laparoscopy in acute care surgeryThe role of laparoscopy in acute care surgery
The role of laparoscopy in acute care surgery
 
Esophagus review 1 Nir Hus MD., PhD.
Esophagus review 1  Nir Hus MD., PhD.Esophagus review 1  Nir Hus MD., PhD.
Esophagus review 1 Nir Hus MD., PhD.
 
Gall bladder carcinoma.04
Gall bladder carcinoma.04Gall bladder carcinoma.04
Gall bladder carcinoma.04
 
Vce
VceVce
Vce
 
Innovative Surgical Techiniques in Hepatobiliary and Pancreatic Surgery
Innovative Surgical Techiniques in Hepatobiliary and Pancreatic SurgeryInnovative Surgical Techiniques in Hepatobiliary and Pancreatic Surgery
Innovative Surgical Techiniques in Hepatobiliary and Pancreatic Surgery
 
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAP
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAPCOMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAP
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAP
 
Clinical Outcomes Of Complicated Diverticulitis Managed Nonoperatively
Clinical Outcomes Of Complicated Diverticulitis Managed NonoperativelyClinical Outcomes Of Complicated Diverticulitis Managed Nonoperatively
Clinical Outcomes Of Complicated Diverticulitis Managed Nonoperatively
 
Ca esophagus
Ca esophagusCa esophagus
Ca esophagus
 
Endoscopy in obesity
Endoscopy in obesityEndoscopy in obesity
Endoscopy in obesity
 
Post operative crohn’s disease
Post operative crohn’s diseasePost operative crohn’s disease
Post operative crohn’s disease
 
Acute massive gastric dilatation a surgical emergency
Acute massive gastric dilatation   a surgical emergencyAcute massive gastric dilatation   a surgical emergency
Acute massive gastric dilatation a surgical emergency
 
Bdi
Bdi Bdi
Bdi
 
Evaluating Current Laparoscopic Applications In Surgery
Evaluating Current Laparoscopic Applications In SurgeryEvaluating Current Laparoscopic Applications In Surgery
Evaluating Current Laparoscopic Applications In Surgery
 
Management of metastatic lymph nodes in gastric cancer
Management of metastatic lymph nodes in gastric cancerManagement of metastatic lymph nodes in gastric cancer
Management of metastatic lymph nodes in gastric cancer
 
New ca stomach mx sneha
New ca stomach mx snehaNew ca stomach mx sneha
New ca stomach mx sneha
 
D2 gastrectomy
D2 gastrectomyD2 gastrectomy
D2 gastrectomy
 

Similar to Drenajul peritoneal continuu ghidat ecografic

Chronic pancreatitis lecture
Chronic pancreatitis lectureChronic pancreatitis lecture
Chronic pancreatitis lecture
Keshri Yadav
 
new panc.pptx
new panc.pptxnew panc.pptx
new panc.pptx
DevaLekshmi1
 
Management of pancreatic fistulas
Management of pancreatic fistulasManagement of pancreatic fistulas
Management of pancreatic fistulas
Abhilash Cheriyan
 
Pancreatitis.pptx
Pancreatitis.pptxPancreatitis.pptx
Pancreatitis.pptx
CRoger3
 
4th-liver.pptx
4th-liver.pptx4th-liver.pptx
4th-liver.pptx
ssuser53e121
 
Optimizing Gastrointestinal Bleeding Scintigraphy
Optimizing Gastrointestinal Bleeding ScintigraphyOptimizing Gastrointestinal Bleeding Scintigraphy
Optimizing Gastrointestinal Bleeding Scintigraphy
Mark Tulchinsky
 
Dynamic Renal scan lecture (2.pdf
Dynamic Renal scan lecture (2.pdfDynamic Renal scan lecture (2.pdf
Dynamic Renal scan lecture (2.pdf
AbdelrhmanHamdy12
 
SURGICAL CONDITIONS OF THE PANCREAS.pptx
SURGICAL CONDITIONS OF THE PANCREAS.pptxSURGICAL CONDITIONS OF THE PANCREAS.pptx
SURGICAL CONDITIONS OF THE PANCREAS.pptx
Biniam24
 
Benign anorectal disease 3 &amp; 4
Benign anorectal disease 3 &amp; 4Benign anorectal disease 3 &amp; 4
Benign anorectal disease 3 &amp; 4
Dr. Azhar
 
Chronic Pancreatitis
Chronic Pancreatitis Chronic Pancreatitis
Chronic Pancreatitis
Prudhvi Krishna
 
Pancreatitis
PancreatitisPancreatitis
Pancreatitis
Clinicas Quirurgicas
 
IVP Best presnetation
IVP Best presnetationIVP Best presnetation
IVP Best presnetation
DR SACHIN SURA
 
Acute pancreatitis
Acute pancreatitisAcute pancreatitis
Acute pancreatitis
Note Noteenote
 
Acute Pancreatitis
Acute PancreatitisAcute Pancreatitis
Acute Pancreatitis
Fatima Hashmi
 
Pancreatic tumors.pptx
Pancreatic tumors.pptxPancreatic tumors.pptx
Pancreatic tumors.pptx
tejasampath
 
Pancreatitis
PancreatitisPancreatitis
Pancreatitis
Aniket Mule
 
ACUTE PANCREATITIS
ACUTE PANCREATITISACUTE PANCREATITIS
ACUTE PANCREATITIS
Muthu Rajathi
 
Acute pancreatitis
Acute pancreatitisAcute pancreatitis
Acute pancreatitis
JabeMohammed
 
Laboratory role in renal replacement therapy.pptx
Laboratory role in renal replacement therapy.pptxLaboratory role in renal replacement therapy.pptx
Laboratory role in renal replacement therapy.pptx
JyotiSharma560718
 
Anselmo A. Cirrosi Epatica e Tumori del Fegato: dalla Resezione al Trapianto....
Anselmo A. Cirrosi Epatica e Tumori del Fegato: dalla Resezione al Trapianto....Anselmo A. Cirrosi Epatica e Tumori del Fegato: dalla Resezione al Trapianto....
Anselmo A. Cirrosi Epatica e Tumori del Fegato: dalla Resezione al Trapianto....
Gianfranco Tammaro
 

Similar to Drenajul peritoneal continuu ghidat ecografic (20)

Chronic pancreatitis lecture
Chronic pancreatitis lectureChronic pancreatitis lecture
Chronic pancreatitis lecture
 
new panc.pptx
new panc.pptxnew panc.pptx
new panc.pptx
 
Management of pancreatic fistulas
Management of pancreatic fistulasManagement of pancreatic fistulas
Management of pancreatic fistulas
 
Pancreatitis.pptx
Pancreatitis.pptxPancreatitis.pptx
Pancreatitis.pptx
 
4th-liver.pptx
4th-liver.pptx4th-liver.pptx
4th-liver.pptx
 
Optimizing Gastrointestinal Bleeding Scintigraphy
Optimizing Gastrointestinal Bleeding ScintigraphyOptimizing Gastrointestinal Bleeding Scintigraphy
Optimizing Gastrointestinal Bleeding Scintigraphy
 
Dynamic Renal scan lecture (2.pdf
Dynamic Renal scan lecture (2.pdfDynamic Renal scan lecture (2.pdf
Dynamic Renal scan lecture (2.pdf
 
SURGICAL CONDITIONS OF THE PANCREAS.pptx
SURGICAL CONDITIONS OF THE PANCREAS.pptxSURGICAL CONDITIONS OF THE PANCREAS.pptx
SURGICAL CONDITIONS OF THE PANCREAS.pptx
 
Benign anorectal disease 3 &amp; 4
Benign anorectal disease 3 &amp; 4Benign anorectal disease 3 &amp; 4
Benign anorectal disease 3 &amp; 4
 
Chronic Pancreatitis
Chronic Pancreatitis Chronic Pancreatitis
Chronic Pancreatitis
 
Pancreatitis
PancreatitisPancreatitis
Pancreatitis
 
IVP Best presnetation
IVP Best presnetationIVP Best presnetation
IVP Best presnetation
 
Acute pancreatitis
Acute pancreatitisAcute pancreatitis
Acute pancreatitis
 
Acute Pancreatitis
Acute PancreatitisAcute Pancreatitis
Acute Pancreatitis
 
Pancreatic tumors.pptx
Pancreatic tumors.pptxPancreatic tumors.pptx
Pancreatic tumors.pptx
 
Pancreatitis
PancreatitisPancreatitis
Pancreatitis
 
ACUTE PANCREATITIS
ACUTE PANCREATITISACUTE PANCREATITIS
ACUTE PANCREATITIS
 
Acute pancreatitis
Acute pancreatitisAcute pancreatitis
Acute pancreatitis
 
Laboratory role in renal replacement therapy.pptx
Laboratory role in renal replacement therapy.pptxLaboratory role in renal replacement therapy.pptx
Laboratory role in renal replacement therapy.pptx
 
Anselmo A. Cirrosi Epatica e Tumori del Fegato: dalla Resezione al Trapianto....
Anselmo A. Cirrosi Epatica e Tumori del Fegato: dalla Resezione al Trapianto....Anselmo A. Cirrosi Epatica e Tumori del Fegato: dalla Resezione al Trapianto....
Anselmo A. Cirrosi Epatica e Tumori del Fegato: dalla Resezione al Trapianto....
 

More from ALEXANDRU ANDRITOIU

Occult cancer screening in thromboembolic disease
Occult cancer screening in thromboembolic diseaseOccult cancer screening in thromboembolic disease
Occult cancer screening in thromboembolic disease
ALEXANDRU ANDRITOIU
 
Carotid atherosclerosis in patients with PAD
Carotid atherosclerosis in patients with PADCarotid atherosclerosis in patients with PAD
Carotid atherosclerosis in patients with PAD
ALEXANDRU ANDRITOIU
 
PULSATILE VENOUS FLOW IN LEGS
PULSATILE VENOUS FLOW IN LEGSPULSATILE VENOUS FLOW IN LEGS
PULSATILE VENOUS FLOW IN LEGS
ALEXANDRU ANDRITOIU
 
PPG and CDUS in venous reflux disease
PPG and CDUS in venous reflux diseasePPG and CDUS in venous reflux disease
PPG and CDUS in venous reflux disease
ALEXANDRU ANDRITOIU
 
Abces de iliopsoas
Abces de iliopsoasAbces de iliopsoas
Abces de iliopsoas
ALEXANDRU ANDRITOIU
 
Occlusion and near occlusion of carotid arteries
Occlusion and near occlusion of carotid arteriesOcclusion and near occlusion of carotid arteries
Occlusion and near occlusion of carotid arteries
ALEXANDRU ANDRITOIU
 
Elastografia in tvp
Elastografia in tvpElastografia in tvp
Elastografia in tvp
ALEXANDRU ANDRITOIU
 
The predictive biomarkers in pts development
The predictive biomarkers in pts developmentThe predictive biomarkers in pts development
The predictive biomarkers in pts development
ALEXANDRU ANDRITOIU
 
Rolul us in ablatia v
Rolul us in ablatia vRolul us in ablatia v
Rolul us in ablatia v
ALEXANDRU ANDRITOIU
 
Abordarea holistica in patologia venoasa
Abordarea holistica in patologia venoasaAbordarea holistica in patologia venoasa
Abordarea holistica in patologia venoasa
ALEXANDRU ANDRITOIU
 
Aderenta si riscul cardiovascul
Aderenta si riscul cardiovasculAderenta si riscul cardiovascul
Aderenta si riscul cardiovascul
ALEXANDRU ANDRITOIU
 
Inflamatia in TVP
Inflamatia in TVPInflamatia in TVP
Inflamatia in TVP
ALEXANDRU ANDRITOIU
 
Indicele de rezistenta carotidian
Indicele de rezistenta carotidianIndicele de rezistenta carotidian
Indicele de rezistenta carotidian
ALEXANDRU ANDRITOIU
 
Us Doppler in evaluarea refluxului venos
Us Doppler in evaluarea refluxului venosUs Doppler in evaluarea refluxului venos
Us Doppler in evaluarea refluxului venos
ALEXANDRU ANDRITOIU
 
Cazuri clinice-drenaje
Cazuri clinice-drenajeCazuri clinice-drenaje
Cazuri clinice-drenaje
ALEXANDRU ANDRITOIU
 
Tromboza venoasa profunda-o provocare terapeutica
Tromboza venoasa profunda-o provocare terapeuticaTromboza venoasa profunda-o provocare terapeutica
Tromboza venoasa profunda-o provocare terapeutica
ALEXANDRU ANDRITOIU
 
Colangiografie percutana transhepatica si drenaj biliar extern
Colangiografie percutana transhepatica si drenaj biliar extern Colangiografie percutana transhepatica si drenaj biliar extern
Colangiografie percutana transhepatica si drenaj biliar extern
ALEXANDRU ANDRITOIU
 
MORPHOLOGIC AND FUNCTIONAL MODIFICATIONS OF COMMON CAROTID ARTERIES IN HYPERT...
MORPHOLOGIC AND FUNCTIONAL MODIFICATIONS OF COMMON CAROTID ARTERIES IN HYPERT...MORPHOLOGIC AND FUNCTIONAL MODIFICATIONS OF COMMON CAROTID ARTERIES IN HYPERT...
MORPHOLOGIC AND FUNCTIONAL MODIFICATIONS OF COMMON CAROTID ARTERIES IN HYPERT...
ALEXANDRU ANDRITOIU
 
Ecografia biliara
Ecografia biliaraEcografia biliara
Ecografia biliara
ALEXANDRU ANDRITOIU
 
ULTRASOUND IN DEEP VENOUS THROMBOSIS
ULTRASOUND IN DEEP VENOUS THROMBOSISULTRASOUND IN DEEP VENOUS THROMBOSIS
ULTRASOUND IN DEEP VENOUS THROMBOSIS
ALEXANDRU ANDRITOIU
 

More from ALEXANDRU ANDRITOIU (20)

Occult cancer screening in thromboembolic disease
Occult cancer screening in thromboembolic diseaseOccult cancer screening in thromboembolic disease
Occult cancer screening in thromboembolic disease
 
Carotid atherosclerosis in patients with PAD
Carotid atherosclerosis in patients with PADCarotid atherosclerosis in patients with PAD
Carotid atherosclerosis in patients with PAD
 
PULSATILE VENOUS FLOW IN LEGS
PULSATILE VENOUS FLOW IN LEGSPULSATILE VENOUS FLOW IN LEGS
PULSATILE VENOUS FLOW IN LEGS
 
PPG and CDUS in venous reflux disease
PPG and CDUS in venous reflux diseasePPG and CDUS in venous reflux disease
PPG and CDUS in venous reflux disease
 
Abces de iliopsoas
Abces de iliopsoasAbces de iliopsoas
Abces de iliopsoas
 
Occlusion and near occlusion of carotid arteries
Occlusion and near occlusion of carotid arteriesOcclusion and near occlusion of carotid arteries
Occlusion and near occlusion of carotid arteries
 
Elastografia in tvp
Elastografia in tvpElastografia in tvp
Elastografia in tvp
 
The predictive biomarkers in pts development
The predictive biomarkers in pts developmentThe predictive biomarkers in pts development
The predictive biomarkers in pts development
 
Rolul us in ablatia v
Rolul us in ablatia vRolul us in ablatia v
Rolul us in ablatia v
 
Abordarea holistica in patologia venoasa
Abordarea holistica in patologia venoasaAbordarea holistica in patologia venoasa
Abordarea holistica in patologia venoasa
 
Aderenta si riscul cardiovascul
Aderenta si riscul cardiovasculAderenta si riscul cardiovascul
Aderenta si riscul cardiovascul
 
Inflamatia in TVP
Inflamatia in TVPInflamatia in TVP
Inflamatia in TVP
 
Indicele de rezistenta carotidian
Indicele de rezistenta carotidianIndicele de rezistenta carotidian
Indicele de rezistenta carotidian
 
Us Doppler in evaluarea refluxului venos
Us Doppler in evaluarea refluxului venosUs Doppler in evaluarea refluxului venos
Us Doppler in evaluarea refluxului venos
 
Cazuri clinice-drenaje
Cazuri clinice-drenajeCazuri clinice-drenaje
Cazuri clinice-drenaje
 
Tromboza venoasa profunda-o provocare terapeutica
Tromboza venoasa profunda-o provocare terapeuticaTromboza venoasa profunda-o provocare terapeutica
Tromboza venoasa profunda-o provocare terapeutica
 
Colangiografie percutana transhepatica si drenaj biliar extern
Colangiografie percutana transhepatica si drenaj biliar extern Colangiografie percutana transhepatica si drenaj biliar extern
Colangiografie percutana transhepatica si drenaj biliar extern
 
MORPHOLOGIC AND FUNCTIONAL MODIFICATIONS OF COMMON CAROTID ARTERIES IN HYPERT...
MORPHOLOGIC AND FUNCTIONAL MODIFICATIONS OF COMMON CAROTID ARTERIES IN HYPERT...MORPHOLOGIC AND FUNCTIONAL MODIFICATIONS OF COMMON CAROTID ARTERIES IN HYPERT...
MORPHOLOGIC AND FUNCTIONAL MODIFICATIONS OF COMMON CAROTID ARTERIES IN HYPERT...
 
Ecografia biliara
Ecografia biliaraEcografia biliara
Ecografia biliara
 
ULTRASOUND IN DEEP VENOUS THROMBOSIS
ULTRASOUND IN DEEP VENOUS THROMBOSISULTRASOUND IN DEEP VENOUS THROMBOSIS
ULTRASOUND IN DEEP VENOUS THROMBOSIS
 

Recently uploaded

Light House Retreats: Plant Medicine Retreat Europe
Light House Retreats: Plant Medicine Retreat EuropeLight House Retreats: Plant Medicine Retreat Europe
Light House Retreats: Plant Medicine Retreat Europe
Lighthouse Retreat
 
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of HyperthyroidismRole of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Dr. Jyothirmai Paindla
 
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Donc Test
 
Journal Article Review on Rasamanikya
Journal Article Review on RasamanikyaJournal Article Review on Rasamanikya
Journal Article Review on Rasamanikya
Dr. Jyothirmai Paindla
 
Top-Vitamin-Supplement-Brands-in-India List
Top-Vitamin-Supplement-Brands-in-India ListTop-Vitamin-Supplement-Brands-in-India List
Top-Vitamin-Supplement-Brands-in-India List
SwisschemDerma
 
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
rishi2789
 
Aortic Association CBL Pilot April 19 – 20 Bern
Aortic Association CBL Pilot April 19 – 20 BernAortic Association CBL Pilot April 19 – 20 Bern
Aortic Association CBL Pilot April 19 – 20 Bern
suvadeepdas911
 
THERAPEUTIC ANTISENSE MOLECULES .pptx
THERAPEUTIC ANTISENSE MOLECULES    .pptxTHERAPEUTIC ANTISENSE MOLECULES    .pptx
THERAPEUTIC ANTISENSE MOLECULES .pptx
70KRISHPATEL
 
Sex determination from mandible pelvis and skull
Sex determination from mandible pelvis and skullSex determination from mandible pelvis and skull
Sex determination from mandible pelvis and skull
ShashankRoodkee
 
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
rishi2789
 
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in IndiaTop 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Swastik Ayurveda
 
The Electrocardiogram - Physiologic Principles
The Electrocardiogram - Physiologic PrinciplesThe Electrocardiogram - Physiologic Principles
The Electrocardiogram - Physiologic Principles
MedicoseAcademics
 
Chapter 11 Nutrition and Chronic Diseases.pptx
Chapter 11 Nutrition and Chronic Diseases.pptxChapter 11 Nutrition and Chronic Diseases.pptx
Chapter 11 Nutrition and Chronic Diseases.pptx
Earlene McNair
 
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptxVestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdfCHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
rishi2789
 
Identification and nursing management of congenital malformations .pptx
Identification and nursing management of congenital malformations .pptxIdentification and nursing management of congenital malformations .pptx
Identification and nursing management of congenital malformations .pptx
MGM SCHOOL/COLLEGE OF NURSING
 
Best Ayurvedic medicine for Gas and Indigestion
Best Ayurvedic medicine for Gas and IndigestionBest Ayurvedic medicine for Gas and Indigestion
Best Ayurvedic medicine for Gas and Indigestion
Swastik Ayurveda
 
Management of Traumatic Splenic injury.pptx
Management of Traumatic Splenic injury.pptxManagement of Traumatic Splenic injury.pptx
Management of Traumatic Splenic injury.pptx
AkshaySarraf1
 
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Oleg Kshivets
 
The Best Ayurvedic Antacid Tablets in India
The Best Ayurvedic Antacid Tablets in IndiaThe Best Ayurvedic Antacid Tablets in India
The Best Ayurvedic Antacid Tablets in India
Swastik Ayurveda
 

Recently uploaded (20)

Light House Retreats: Plant Medicine Retreat Europe
Light House Retreats: Plant Medicine Retreat EuropeLight House Retreats: Plant Medicine Retreat Europe
Light House Retreats: Plant Medicine Retreat Europe
 
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of HyperthyroidismRole of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
 
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
 
Journal Article Review on Rasamanikya
Journal Article Review on RasamanikyaJournal Article Review on Rasamanikya
Journal Article Review on Rasamanikya
 
Top-Vitamin-Supplement-Brands-in-India List
Top-Vitamin-Supplement-Brands-in-India ListTop-Vitamin-Supplement-Brands-in-India List
Top-Vitamin-Supplement-Brands-in-India List
 
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
 
Aortic Association CBL Pilot April 19 – 20 Bern
Aortic Association CBL Pilot April 19 – 20 BernAortic Association CBL Pilot April 19 – 20 Bern
Aortic Association CBL Pilot April 19 – 20 Bern
 
THERAPEUTIC ANTISENSE MOLECULES .pptx
THERAPEUTIC ANTISENSE MOLECULES    .pptxTHERAPEUTIC ANTISENSE MOLECULES    .pptx
THERAPEUTIC ANTISENSE MOLECULES .pptx
 
Sex determination from mandible pelvis and skull
Sex determination from mandible pelvis and skullSex determination from mandible pelvis and skull
Sex determination from mandible pelvis and skull
 
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
 
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in IndiaTop 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
 
The Electrocardiogram - Physiologic Principles
The Electrocardiogram - Physiologic PrinciplesThe Electrocardiogram - Physiologic Principles
The Electrocardiogram - Physiologic Principles
 
Chapter 11 Nutrition and Chronic Diseases.pptx
Chapter 11 Nutrition and Chronic Diseases.pptxChapter 11 Nutrition and Chronic Diseases.pptx
Chapter 11 Nutrition and Chronic Diseases.pptx
 
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptxVestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
 
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdfCHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
 
Identification and nursing management of congenital malformations .pptx
Identification and nursing management of congenital malformations .pptxIdentification and nursing management of congenital malformations .pptx
Identification and nursing management of congenital malformations .pptx
 
Best Ayurvedic medicine for Gas and Indigestion
Best Ayurvedic medicine for Gas and IndigestionBest Ayurvedic medicine for Gas and Indigestion
Best Ayurvedic medicine for Gas and Indigestion
 
Management of Traumatic Splenic injury.pptx
Management of Traumatic Splenic injury.pptxManagement of Traumatic Splenic injury.pptx
Management of Traumatic Splenic injury.pptx
 
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
 
The Best Ayurvedic Antacid Tablets in India
The Best Ayurvedic Antacid Tablets in IndiaThe Best Ayurvedic Antacid Tablets in India
The Best Ayurvedic Antacid Tablets in India
 

Drenajul peritoneal continuu ghidat ecografic