Obstrucción intestinal por bridas

La obstrucción intestinal es una urgencia quirúrgica que ocurre cuando hay una interrupción total o parcial del tránsito del contenido intestinal, caracterizada por un cuadro de dolor abdominal tipo cólico, náuseas, vómitos, distensión abdominal y paro de fecales y flatos (obstipación). Alrededor de...

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Autores:
Mendez Cortina, Yorjagis Andres
Lopera, Katherine
Tipo de recurso:
Fecha de publicación:
2025
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
spa
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/48078
Acceso en línea:
https://hdl.handle.net/10495/48078
Palabra clave:
Obstrucción intestinal
Dolor Abdominal
Peritoneo
Intestinal Obstruction
Abdominal Pain
Peritoneum
https://id.nlm.nih.gov/mesh/D010537
https://id.nlm.nih.gov/mesh/D015746
https://id.nlm.nih.gov/mesh/D007415
ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
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openAccess
License
http://creativecommons.org/licenses/by-nc-sa/4.0/
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dc.title.none.fl_str_mv Obstrucción intestinal por bridas
dc.title.translated.none.fl_str_mv Intestinal obstruction due to bands
title Obstrucción intestinal por bridas
spellingShingle Obstrucción intestinal por bridas
Obstrucción intestinal
Dolor Abdominal
Peritoneo
Intestinal Obstruction
Abdominal Pain
Peritoneum
https://id.nlm.nih.gov/mesh/D010537
https://id.nlm.nih.gov/mesh/D015746
https://id.nlm.nih.gov/mesh/D007415
ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
title_short Obstrucción intestinal por bridas
title_full Obstrucción intestinal por bridas
title_fullStr Obstrucción intestinal por bridas
title_full_unstemmed Obstrucción intestinal por bridas
title_sort Obstrucción intestinal por bridas
dc.creator.fl_str_mv Mendez Cortina, Yorjagis Andres
Lopera, Katherine
dc.contributor.author.none.fl_str_mv Mendez Cortina, Yorjagis Andres
Lopera, Katherine
dc.contributor.researchgroup.none.fl_str_mv Inmunovirología
dc.subject.decs.none.fl_str_mv Obstrucción intestinal
Dolor Abdominal
Peritoneo
Intestinal Obstruction
Abdominal Pain
Peritoneum
topic Obstrucción intestinal
Dolor Abdominal
Peritoneo
Intestinal Obstruction
Abdominal Pain
Peritoneum
https://id.nlm.nih.gov/mesh/D010537
https://id.nlm.nih.gov/mesh/D015746
https://id.nlm.nih.gov/mesh/D007415
ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
dc.subject.meshuri.none.fl_str_mv https://id.nlm.nih.gov/mesh/D010537
https://id.nlm.nih.gov/mesh/D015746
https://id.nlm.nih.gov/mesh/D007415
dc.subject.ods.none.fl_str_mv ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
description La obstrucción intestinal es una urgencia quirúrgica que ocurre cuando hay una interrupción total o parcial del tránsito del contenido intestinal, caracterizada por un cuadro de dolor abdominal tipo cólico, náuseas, vómitos, distensión abdominal y paro de fecales y flatos (obstipación). Alrededor del 60 al 75 % de los casos de obstrucción intestinal son secundarios a bridas, las cuales en su mayoría son adquiridas luego de procedimientos quirúrgicos abdominopélvicos; el otro 40-25 % de los casos son producto de neoplasias, hernias, enfermedad inflamatoria intestinal, vólvulos, entre otros (1). [Tomado de: ¿Qué es la obstrucción intestinal? ]
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-11-03T15:21:04Z
dc.date.issued.none.fl_str_mv 2025
dc.type.none.fl_str_mv Artículo de revista
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dc.identifier.citation.none.fl_str_mv Mendez YA, Lopera K. Obstrucción intestinal por bridas 2022 [Internet]. Medellín: Perlas Clínicas, Facultad de Medicina, Universidad de Antioquia; 2022 [acceso día de mes de año]. DOI: https://doi.org/10.59473/medudea.pc.2023.43
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/10495/48078
dc.identifier.doi.none.fl_str_mv 10.59473/medudea.pc.2023.43
identifier_str_mv Mendez YA, Lopera K. Obstrucción intestinal por bridas 2022 [Internet]. Medellín: Perlas Clínicas, Facultad de Medicina, Universidad de Antioquia; 2022 [acceso día de mes de año]. DOI: https://doi.org/10.59473/medudea.pc.2023.43
10.59473/medudea.pc.2023.43
url https://hdl.handle.net/10495/48078
dc.language.iso.none.fl_str_mv spa
language spa
dc.relation.references.none.fl_str_mv Jackson P, Vigiola Cruz M. Intestinal Obstruction: Evaluation and Management. Am Fam Physician [Internet]. 2018 Sep 15;98(6):362-367. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/30215917/
Tong JWV, Lingam P, Shelat VG. Adhesive small bowel obstruction – an update. Acute Med Surg [Internet]. 2020 Nov 4;7(1):e587. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/33173587/
Ten Broek RPG, Krielen P, Di Saverio S, Coccolini F, Biffl WL, Ansaloni L, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg [Internet]. 2018 Jun 19;13:24. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/29946347/
Attard JA, MacLean AR. Adhesive small bowel obstruction: epidemiology, biology and prevention. Can J Surg [Internet]. 2007 Aug;50(4):291-300. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/17897517/
Bordeianou L, Dante D, Kao L, Hockberger R, Chen W. Etiologies, clinical manifestations, and diagnosis of mechanical small bowel obstruction in adults. UpToDate.com [Internet]. 2020 [cited 2021 Oct 11];65. Available from: https://www.uptodate.com/contents/etiologies-clinical-manifestations-and-diagnosis-of-mechanical-small-bowel-obstruction-in-adults?search=obstruccion intestinal&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H13713325
Sebastian-Valverde E, Poves I, Membrilla-Fernández E, Pons-Fragero MJ, Grande L. The role of the laparoscopic approach in the surgical management of acute adhesive small bowel obstruction. BMC Surg [Internet]. 2019 Apr 24;19(1):40. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/31014318/
Nelms DW, Kann BR. Imaging Modalities for Evaluation of Intestinal Obstruction. Clin Colon Rectal Surg [Internet]. 2021 Jul;34(4):205-218. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/34305469/
Ceresoli M, Coccolini F, Catena F, Montori G, Di Saverio S, Sartelli M, et al. Water-soluble contrast agent in adhesive small bowel obstruction: a systematic review and meta-analysis of diagnostic and therapeutic value. Am J Surg [Internet]. 2016 Jun;211(6):1114-25. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/26329902/
Liliana Bordeianou, MD, MPH, Daniel Dante Yeh M. Management of small bowel obstruction in adults – UpToDate. UpToDate® [Internet]. 2020 [cited 2021 Oct 11];1–31. Available from: https://www.uptodate.com/contents/management-of-small-bowel-obstruction-in-adults?search=obstruccion intestinal&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H1977721991
Idrobo AA, Bastidas BE, Yasno LM, Vargas AL, Merchán Galvis AM. Presentación y desenlace del manejo conservador en obstrucción intestinal por bridas en el Cauca. Rev Colomb Gastroenterol [Internet]. 2020;35(4):447–54. Available from: https://revistagastrocol.com/index.php/rcg/article/view/517/968
Amara Y, Leppaniemi A, Catena F, Ansaloni L, Sugrue M, Fraga GP, et al. Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper. World J Emerg Surg [Internet]. 2021 Jul 3;16(1):36. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/34217331/
Sallinen V, Di Saverio S, Haukijärvi E, Juusela R, Wikström H, Koivukangas V, et al. Laparoscopic versus open adhesiolysis for adhesive small bowel obstruction (LASSO): an international, multicentre, randomised, open-label trial. Lancet Gastroenterol Hepatol [Internet]. 2019 Apr;4(4):278-286. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/30765264/
dc.relation.ispartofjournal.none.fl_str_mv Perlas clínicas
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dc.format.extent.none.fl_str_mv 15 páginas
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dc.publisher.none.fl_str_mv Universidad de Antioquia, Facultad de Medicina
dc.publisher.place.none.fl_str_mv Medellín, Colombia
publisher.none.fl_str_mv Universidad de Antioquia, Facultad de Medicina
institution Universidad de Antioquia
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spelling Mendez Cortina, Yorjagis AndresLopera, KatherineInmunovirología2025-11-03T15:21:04Z2025Mendez YA, Lopera K. Obstrucción intestinal por bridas 2022 [Internet]. Medellín: Perlas Clínicas, Facultad de Medicina, Universidad de Antioquia; 2022 [acceso día de mes de año]. DOI: https://doi.org/10.59473/medudea.pc.2023.43https://hdl.handle.net/10495/4807810.59473/medudea.pc.2023.43La obstrucción intestinal es una urgencia quirúrgica que ocurre cuando hay una interrupción total o parcial del tránsito del contenido intestinal, caracterizada por un cuadro de dolor abdominal tipo cólico, náuseas, vómitos, distensión abdominal y paro de fecales y flatos (obstipación). Alrededor del 60 al 75 % de los casos de obstrucción intestinal son secundarios a bridas, las cuales en su mayoría son adquiridas luego de procedimientos quirúrgicos abdominopélvicos; el otro 40-25 % de los casos son producto de neoplasias, hernias, enfermedad inflamatoria intestinal, vólvulos, entre otros (1). [Tomado de: ¿Qué es la obstrucción intestinal? ]COL001244415 páginasapplication/pdfspaUniversidad de Antioquia, Facultad de MedicinaMedellín, Colombiahttp://creativecommons.org/licenses/by-nc-sa/4.0/info:eu-repo/semantics/openAccessAttribution-NonCommercial-ShareAlike 4.0 Internationalhttp://purl.org/coar/access_right/c_abf2Obstrucción intestinal por bridasIntestinal obstruction due to bandsArtículo de revistahttp://purl.org/coar/resource_type/c_3e5ahttps://purl.org/redcol/resource_type/GCTexthttp://purl.org/coar/version/c_b1a7d7d4d402bcceinfo:eu-repo/semantics/contributionToPeriodicalinfo:eu-repo/semantics/draftJackson P, Vigiola Cruz M. Intestinal Obstruction: Evaluation and Management. Am Fam Physician [Internet]. 2018 Sep 15;98(6):362-367. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/30215917/Tong JWV, Lingam P, Shelat VG. Adhesive small bowel obstruction – an update. Acute Med Surg [Internet]. 2020 Nov 4;7(1):e587. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/33173587/Ten Broek RPG, Krielen P, Di Saverio S, Coccolini F, Biffl WL, Ansaloni L, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg [Internet]. 2018 Jun 19;13:24. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/29946347/Attard JA, MacLean AR. Adhesive small bowel obstruction: epidemiology, biology and prevention. Can J Surg [Internet]. 2007 Aug;50(4):291-300. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/17897517/Bordeianou L, Dante D, Kao L, Hockberger R, Chen W. Etiologies, clinical manifestations, and diagnosis of mechanical small bowel obstruction in adults. UpToDate.com [Internet]. 2020 [cited 2021 Oct 11];65. Available from: https://www.uptodate.com/contents/etiologies-clinical-manifestations-and-diagnosis-of-mechanical-small-bowel-obstruction-in-adults?search=obstruccion intestinal&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H13713325Sebastian-Valverde E, Poves I, Membrilla-Fernández E, Pons-Fragero MJ, Grande L. The role of the laparoscopic approach in the surgical management of acute adhesive small bowel obstruction. BMC Surg [Internet]. 2019 Apr 24;19(1):40. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/31014318/Nelms DW, Kann BR. Imaging Modalities for Evaluation of Intestinal Obstruction. Clin Colon Rectal Surg [Internet]. 2021 Jul;34(4):205-218. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/34305469/Ceresoli M, Coccolini F, Catena F, Montori G, Di Saverio S, Sartelli M, et al. Water-soluble contrast agent in adhesive small bowel obstruction: a systematic review and meta-analysis of diagnostic and therapeutic value. Am J Surg [Internet]. 2016 Jun;211(6):1114-25. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/26329902/Liliana Bordeianou, MD, MPH, Daniel Dante Yeh M. Management of small bowel obstruction in adults – UpToDate. UpToDate® [Internet]. 2020 [cited 2021 Oct 11];1–31. Available from: https://www.uptodate.com/contents/management-of-small-bowel-obstruction-in-adults?search=obstruccion intestinal&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H1977721991Idrobo AA, Bastidas BE, Yasno LM, Vargas AL, Merchán Galvis AM. Presentación y desenlace del manejo conservador en obstrucción intestinal por bridas en el Cauca. Rev Colomb Gastroenterol [Internet]. 2020;35(4):447–54. Available from: https://revistagastrocol.com/index.php/rcg/article/view/517/968Amara Y, Leppaniemi A, Catena F, Ansaloni L, Sugrue M, Fraga GP, et al. Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper. World J Emerg Surg [Internet]. 2021 Jul 3;16(1):36. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/34217331/Sallinen V, Di Saverio S, Haukijärvi E, Juusela R, Wikström H, Koivukangas V, et al. Laparoscopic versus open adhesiolysis for adhesive small bowel obstruction (LASSO): an international, multicentre, randomised, open-label trial. Lancet Gastroenterol Hepatol [Internet]. 2019 Apr;4(4):278-286. Available from: https://pubmed-ncbi-nlm-nih-gov.udea.lookproxy.com/30765264/Perlas clínicasObstrucción intestinalDolor AbdominalPeritoneoIntestinal ObstructionAbdominal PainPeritoneumhttps://id.nlm.nih.gov/mesh/D010537https://id.nlm.nih.gov/mesh/D015746https://id.nlm.nih.gov/mesh/D007415ODS 3: Salud y bienestar. 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ltbywgc2kgZnVlcmUgYXBsaWNhYmxlKSwgeS9vIChpaSkgZWwgbm9tYnJlIGRlIGxhIHBhcnRlIG8gbGFzIHBhcnRlcyBxdWUgZWwgQXV0b3IgT3JpZ2luYWwgeS9vIGVsIExpY2VuY2lhbnRlIGh1YmllcmVuIGRlc2lnbmFkbyBwYXJhIGxhIGF0cmlidWNpw7NuICh2LmcuLCB1biBpbnN0aXR1dG8gcGF0cm9jaW5hZG9yLCBlZGl0b3JpYWwsIHB1YmxpY2FjacOzbikgZW4gbGEgaW5mb3JtYWNpw7NuIGRlIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBkZWwgTGljZW5jaWFudGUsIHTDqXJtaW5vcyBkZSBzZXJ2aWNpb3MgbyBkZSBvdHJhcyBmb3JtYXMgcmF6b25hYmxlczsgZWwgdMOtdHVsbyBkZSBsYSBPYnJhIHNpIGVzdMOhIHByb3Zpc3RvOyBlbiBsYSBtZWRpZGEgZGUgbG8gcmF6b25hYmxlbWVudGUgZmFjdGlibGUgeSwgc2kgZXN0w6EgcHJvdmlzdG8sIGVsIElkZW50aWZpY2Fkb3IgVW5pZm9ybWUgZGUgUmVjdXJzb3MgKFVuaWZvcm0gUmVzb3VyY2UgSWRlbnRpZmllcikgcXVlIGVsIExpY2VuY2lhbnRlIGVzcGVjaWZpY2EgcGFyYSBzZXIgYXNvY2lhZG8gY29uIGxhIE9icmEsIHNhbHZvIHF1ZSB0YWwgVVJJIG5vIHNlIHJlZmllcmEgYSBsYSBub3RhIHNvYnJlIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBvIGEgbGEgaW5mb3JtYWNpw7NuIHNvYnJlIGVsIGxpY2VuY2lhbWllbnRvIGRlIGxhIE9icmE7IHkgZW4gZWwgY2FzbyBkZSB1bmEgT2JyYSBEZXJpdmFkYSwgYXRyaWJ1aXIgZWwgY3LDqWRpdG8gaWRlbnRpZmljYW5kbyBlbCB1c28gZGUgbGEgT2JyYSBlbiBsYSBPYnJhIERlcml2YWRhICh2LmcuLCAiVHJhZHVjY2nDs24gRnJhbmNlc2EgZGUgbGEgT2JyYSBkZWwgQXV0b3IgT3JpZ2luYWwsIiBvICJHdWnDs24gQ2luZW1hdG9ncsOhZmljbyBiYXNhZG8gZW4gbGEgT2JyYSBvcmlnaW5hbCBkZWwgQXV0b3IgT3JpZ2luYWwiKS4gVGFsIGNyw6lkaXRvIHB1ZWRlIHNlciBpbXBsZW1lbnRhZG8gZGUgY3VhbHF1aWVyIGZvcm1hIHJhem9uYWJsZTsgZW4gZWwgY2Fzbywgc2luIGVtYmFyZ28sIGRlIE9icmFzIERlcml2YWRhcyB1IE9icmFzIENvbGVjdGl2YXMsIHRhbCBjcsOpZGl0byBhcGFyZWNlcsOhLCBjb21vIG3DrW5pbW8sIGRvbmRlIGFwYXJlY2UgZWwgY3LDqWRpdG8gZGUgY3VhbHF1aWVyIG90cm8gYXV0b3IgY29tcGFyYWJsZSB5IGRlIHVuYSBtYW5lcmEsIGFsIG1lbm9zLCB0YW4gZGVzdGFjYWRhIGNvbW8gZWwgY3LDqWRpdG8gZGUgb3RybyBhdXRvciBjb21wYXJhYmxlLiAgCmQuIFBhcmEgZXZpdGFyIHRvZGEgY29uZnVzacOzbiwgZWwgTGljZW5jaWFudGUgYWNsYXJhIHF1ZSwgY3VhbmRvIGxhIG9icmEgZXMgdW5hIGNvbXBvc2ljacOzbiBtdXNpY2FsOgoKaS4gUmVnYWzDrWFzIHBvciBpbnRlcnByZXRhY2nDs24geSBlamVjdWNpw7NuIGJham8gbGljZW5jaWFzIGdlbmVyYWxlcy4gRWwgTGljZW5jaWFudGUgc2UgcmVzZXJ2YSBlbCBkZXJlY2hvIGV4Y2x1c2l2byBkZSBhdXRvcml6YXIgbGEgZWplY3VjacOzbiBww7pibGljYSBvIGxhIGVqZWN1Y2nDs24gcMO6YmxpY2EgZGlnaXRhbCBkZSBsYSBvYnJhIHkgZGUgcmVjb2xlY3Rhciwgc2VhIGluZGl2aWR1YWxtZW50ZSBvIGEgdHJhdsOpcyBkZSB1bmEgc29jaWVkYWQgZGUgZ2VzdGnDs24gY29sZWN0aXZhIGRlIGRlcmVjaG9zIGRlIGF1dG9yIHkgZGVyZWNob3MgY29uZXhvcyAocG9yIGVqZW1wbG8sIFNBWUNPKSwgbGFzIHJlZ2Fsw61hcyBwb3IgbGEgZWplY3VjacOzbiBww7pibGljYSBvIHBvciBsYSBlamVjdWNpw7NuIHDDumJsaWNhIGRpZ2l0YWwgZGUgbGEgb2JyYSAocG9yIGVqZW1wbG8gV2ViY2FzdCkgbGljZW5jaWFkYSBiYWpvIGxpY2VuY2lhcyBnZW5lcmFsZXMsIHNpIGxhIGludGVycHJldGFjacOzbiBvIGVqZWN1Y2nDs24gZGUgbGEgb2JyYSBlc3TDoSBwcmltb3JkaWFsbWVudGUgb3JpZW50YWRhIHBvciBvIGRpcmlnaWRhIGEgbGEgb2J0ZW5jacOzbiBkZSB1bmEgdmVudGFqYSBjb21lcmNpYWwgbyB1bmEgY29tcGVuc2FjacOzbiBtb25ldGFyaWEgcHJpdmFkYS4KaWkuIFJlZ2Fsw61hcyBwb3IgRm9ub2dyYW1hcy4gRWwgTGljZW5jaWFudGUgc2UgcmVzZXJ2YSBlbCBkZXJlY2hvIGV4Y2x1c2l2byBkZSByZWNvbGVjdGFyLCBpbmRpdmlkdWFsbWVudGUgbyBhIHRyYXbDqXMgZGUgdW5hIHNvY2llZGFkIGRlIGdlc3Rpw7NuIGNvbGVjdGl2YSBkZSBkZXJlY2hvcyBkZSBhdXRvciB5IGRlcmVjaG9zIGNvbmV4b3MgKHBvciBlamVtcGxvLCBsb3MgY29uc2FncmFkb3MgcG9yIGxhIFNBWUNPKSwgdW5hIGFnZW5jaWEgZGUgZGVyZWNob3MgbXVzaWNhbGVzIG8gYWxnw7puIGFnZW50ZSBkZXNpZ25hZG8sIGxhcyByZWdhbMOtYXMgcG9yIGN1YWxxdWllciBmb25vZ3JhbWEgcXVlIFVzdGVkIGNyZWUgYSBwYXJ0aXIgZGUgbGEgb2JyYSAo4oCcdmVyc2nDs24gY292ZXLigJ0pIHkgZGlzdHJpYnV5YSwgZW4gbG9zIHTDqXJtaW5vcyBkZWwgcsOpZ2ltZW4gZGUgZGVyZWNob3MgZGUgYXV0b3IsIHNpIGxhIGNyZWFjacOzbiBvIGRpc3RyaWJ1Y2nDs24gZGUgZXNhIHZlcnNpw7NuIGNvdmVyIGVzdMOhIHByaW1vcmRpYWxtZW50ZSBkZXN0aW5hZGEgbyBkaXJpZ2lkYSBhIG9idGVuZXIgdW5hIHZlbnRhamEgY29tZXJjaWFsIG8gdW5hIGNvbXBlbnNhY2nDs24gbW9uZXRhcmlhIHByaXZhZGEuCiAgICAgIAplLiBHZXN0acOzbiBkZSBEZXJlY2hvcyBkZSBBdXRvciBzb2JyZSBJbnRlcnByZXRhY2lvbmVzIHkgRWplY3VjaW9uZXMgRGlnaXRhbGVzIChXZWJDYXN0aW5nKS4gUGFyYSBldml0YXIgdG9kYSBjb25mdXNpw7NuLCBlbCBMaWNlbmNpYW50ZSBhY2xhcmEgcXVlLCBjdWFuZG8gbGEgb2JyYSBzZWEgdW4gZm9ub2dyYW1hLCBlbCBMaWNlbmNpYW50ZSBzZSByZXNlcnZhIGVsIGRlcmVjaG8gZXhjbHVzaXZvIGRlIGF1dG9yaXphciBsYSBlamVjdWNpw7NuIHDDumJsaWNhIGRpZ2l0YWwgZGUgbGEgb2JyYSAocG9yIGVqZW1wbG8sIHdlYmNhc3QpIHkgZGUgcmVjb2xlY3RhciwgaW5kaXZpZHVhbG1lbnRlIG8gYSB0cmF2w6lzIGRlIHVuYSBzb2NpZWRhZCBkZSBnZXN0acOzbiBjb2xlY3RpdmEgZGUgZGVyZWNob3MgZGUgYXV0b3IgeSBkZXJlY2hvcyBjb25leG9zIChwb3IgZWplbXBsbywgQUNJTlBSTyksIGxhcyByZWdhbMOtYXMgcG9yIGxhIGVqZWN1Y2nDs24gcMO6YmxpY2EgZGlnaXRhbCBkZSBsYSBvYnJhIChwb3IgZWplbXBsbywgd2ViY2FzdCksIHN1amV0YSBhIGxhcyBkaXNwb3NpY2lvbmVzIGFwbGljYWJsZXMgZGVsIHLDqWdpbWVuIGRlIERlcmVjaG8gZGUgQXV0b3IsIHNpIGVzdGEgZWplY3VjacOzbiBww7pibGljYSBkaWdpdGFsIGVzdMOhIHByaW1vcmRpYWxtZW50ZSBkaXJpZ2lkYSBhIG9idGVuZXIgdW5hIHZlbnRhamEgY29tZXJjaWFsIG8gdW5hIGNvbXBlbnNhY2nDs24gbW9uZXRhcmlhIHByaXZhZGEuCiAgCjUuIFJlcHJlc2VudGFjaW9uZXMsIEdhcmFudMOtYXMgeSBMaW1pdGFjaW9uZXMgZGUgUmVzcG9uc2FiaWxpZGFkLgpBIE1FTk9TIFFVRSBMQVMgUEFSVEVTIExPIEFDT1JEQVJBTiBERSBPVFJBIEZPUk1BIFBPUiBFU0NSSVRPLCBFTCBMSUNFTkNJQU5URSBPRlJFQ0UgTEEgT0JSQSAoRU4gRUwgRVNUQURPIEVOIEVMIFFVRSBTRSBFTkNVRU5UUkEpIOKAnFRBTCBDVUFM4oCdLCBTSU4gQlJJTkRBUiBHQVJBTlTDjUFTIERFIENMQVNFIEFMR1VOQSBSRVNQRUNUTyBERSBMQSBPQlJBLCBZQSBTRUEgRVhQUkVTQSwgSU1QTMONQ0lUQSwgTEVHQUwgTyBDVUFMUVVJRVJBIE9UUkEsIElOQ0xVWUVORE8sIFNJTiBMSU1JVEFSU0UgQSBFTExBUywgR0FSQU5Uw41BUyBERSBUSVRVTEFSSURBRCwgQ09NRVJDSUFCSUxJREFELCBBREFQVEFCSUxJREFEIE8gQURFQ1VBQ0nDk04gQSBQUk9Qw5NTSVRPIERFVEVSTUlOQURPLCBBVVNFTkNJQSBERSBJTkZSQUNDScOTTiwgREUgQVVTRU5DSUEgREUgREVGRUNUT1MgTEFURU5URVMgTyBERSBPVFJPIFRJUE8sIE8gTEEgUFJFU0VOQ0lBIE8gQVVTRU5DSUEgREUgRVJST1JFUywgU0VBTiBPIE5PIERFU0NVQlJJQkxFUyAoUFVFREFOIE8gTk8gU0VSIEVTVE9TIERFU0NVQklFUlRPUykuIEFMR1VOQVMgSlVSSVNESUNDSU9ORVMgTk8gUEVSTUlURU4gTEEgRVhDTFVTScOTTiBERSBHQVJBTlTDjUFTIElNUEzDjUNJVEFTLCBFTiBDVVlPIENBU08gRVNUQSBFWENMVVNJw5NOIFBVRURFIE5PIEFQTElDQVJTRSBBIFVTVEVELgogIAo2LiBMaW1pdGFjacOzbiBkZSByZXNwb25zYWJpbGlkYWQuCkEgTUVOT1MgUVVFIExPIEVYSUpBIEVYUFJFU0FNRU5URSBMQSBMRVkgQVBMSUNBQkxFLCBFTCBMSUNFTkNJQU5URSBOTyBTRVLDgSBSRVNQT05TQUJMRSBBTlRFIFVTVEVEIFBPUiBEQcORTyBBTEdVTk8sIFNFQSBQT1IgUkVTUE9OU0FCSUxJREFEIEVYVFJBQ09OVFJBQ1RVQUwsIFBSRUNPTlRSQUNUVUFMIE8gQ09OVFJBQ1RVQUwsIE9CSkVUSVZBIE8gU1VCSkVUSVZBLCBTRSBUUkFURSBERSBEQcORT1MgTU9SQUxFUyBPIFBBVFJJTU9OSUFMRVMsIERJUkVDVE9TIE8gSU5ESVJFQ1RPUywgUFJFVklTVE9TIE8gSU1QUkVWSVNUT1MgUFJPRFVDSURPUyBQT1IgRUwgVVNPIERFIEVTVEEgTElDRU5DSUEgTyBERSBMQSBPQlJBLCBBVU4gQ1VBTkRPIEVMIExJQ0VOQ0lBTlRFIEhBWUEgU0lETyBBRFZFUlRJRE8gREUgTEEgUE9TSUJJTElEQUQgREUgRElDSE9TIERBw5FPUy4gQUxHVU5BUyBMRVlFUyBOTyBQRVJNSVRFTiBMQSBFWENMVVNJw5NOIERFIENJRVJUQSBSRVNQT05TQUJJTElEQUQsIEVOIENVWU8gQ0FTTyBFU1RBIEVYQ0xVU0nDk04gUFVFREUgTk8gQVBMSUNBUlNFIEEgVVNURUQuCiAgCjcuIFTDqXJtaW5vLgkKYS4gRXN0YSBMaWNlbmNpYSB5IGxvcyBkZXJlY2hvcyBvdG9yZ2Fkb3MgZW4gdmlydHVkIGRlIGVsbGEgdGVybWluYXLDoW4gYXV0b23DoXRpY2FtZW50ZSBzaSBVc3RlZCBpbmZyaW5nZSBhbGd1bmEgY29uZGljacOzbiBlc3RhYmxlY2lkYSBlbiBlbGxhLiBTaW4gZW1iYXJnbywgbG9zIGluZGl2aWR1b3MgbyBlbnRpZGFkZXMgcXVlIGhhbiByZWNpYmlkbyBPYnJhcyBEZXJpdmFkYXMgbyBDb2xlY3RpdmFzIGRlIFVzdGVkIGRlIGNvbmZvcm1pZGFkIGNvbiBlc3RhIExpY2VuY2lhLCBubyB2ZXLDoW4gdGVybWluYWRhcyBzdXMgbGljZW5jaWFzLCBzaWVtcHJlIHF1ZSBlc3RvcyBpbmRpdmlkdW9zIG8gZW50aWRhZGVzIHNpZ2FuIGN1bXBsaWVuZG8gw61udGVncmFtZW50ZSBsYXMgY29uZGljaW9uZXMgZGUgZXN0YXMgbGljZW5jaWFzLiBMYXMgU2VjY2lvbmVzIDEsIDIsIDUsIDYsIDcsIHkgOCBzdWJzaXN0aXLDoW4gYSBjdWFscXVpZXIgdGVybWluYWNpw7NuIGRlIGVzdGEgTGljZW5jaWEuCmIuIFN1amV0YSBhIGxhcyBjb25kaWNpb25lcyB5IHTDqXJtaW5vcyBhbnRlcmlvcmVzLCBsYSBsaWNlbmNpYSBvdG9yZ2FkYSBhcXXDrSBlcyBwZXJwZXR1YSAoZHVyYW50ZSBlbCBwZXLDrW9kbyBkZSB2aWdlbmNpYSBkZSBsb3MgZGVyZWNob3MgZGUgYXV0b3IgZGUgbGEgb2JyYSkuIE5vIG9ic3RhbnRlIGxvIGFudGVyaW9yLCBlbCBMaWNlbmNpYW50ZSBzZSByZXNlcnZhIGVsIGRlcmVjaG8gYSBwdWJsaWNhciB5L28gZXN0cmVuYXIgbGEgT2JyYSBiYWpvIGNvbmRpY2lvbmVzIGRlIGxpY2VuY2lhIGRpZmVyZW50ZXMgbyBhIGRlamFyIGRlIGRpc3RyaWJ1aXJsYSBlbiBsb3MgdMOpcm1pbm9zIGRlIGVzdGEgTGljZW5jaWEgZW4gY3VhbHF1aWVyIG1vbWVudG87IGVuIGVsIGVudGVuZGlkbywgc2luIGVtYmFyZ28sIHF1ZSBlc2EgZWxlY2Npw7NuIG5vIHNlcnZpcsOhIHBhcmEgcmV2b2NhciBlc3RhIGxpY2VuY2lhIG8gcXVlIGRlYmEgc2VyIG90b3JnYWRhICwgYmFqbyBsb3MgdMOpcm1pbm9zIGRlIGVzdGEgbGljZW5jaWEpLCB5IGVzdGEgbGljZW5jaWEgY29udGludWFyw6EgZW4gcGxlbm8gdmlnb3IgeSBlZmVjdG8gYSBtZW5vcyBxdWUgc2VhIHRlcm1pbmFkYSBjb21vIHNlIGV4cHJlc2EgYXRyw6FzLiBMYSBMaWNlbmNpYSByZXZvY2FkYSBjb250aW51YXLDoSBzaWVuZG8gcGxlbmFtZW50ZSB2aWdlbnRlIHkgZWZlY3RpdmEgc2kgbm8gc2UgbGUgZGEgdMOpcm1pbm8gZW4gbGFzIGNvbmRpY2lvbmVzIGluZGljYWRhcyBhbnRlcmlvcm1lbnRlLgogIAo4LiBWYXJpb3MuCmEuIENhZGEgdmV6IHF1ZSBVc3RlZCBkaXN0cmlidXlhIG8gcG9uZ2EgYSBkaXNwb3NpY2nDs24gcMO6YmxpY2EgbGEgT2JyYSBvIHVuYSBPYnJhIENvbGVjdGl2YSwgZWwgTGljZW5jaWFudGUgb2ZyZWNlcsOhIGFsIGRlc3RpbmF0YXJpbyB1bmEgbGljZW5jaWEgZW4gbG9zIG1pc21vcyB0w6lybWlub3MgeSBjb25kaWNpb25lcyBxdWUgbGEgbGljZW5jaWEgb3RvcmdhZGEgYSBVc3RlZCBiYWpvIGVzdGEgTGljZW5jaWEuCmIuIFNpIGFsZ3VuYSBkaXNwb3NpY2nDs24gZGUgZXN0YSBMaWNlbmNpYSByZXN1bHRhIGludmFsaWRhZGEgbyBubyBleGlnaWJsZSwgc2Vnw7puIGxhIGxlZ2lzbGFjacOzbiB2aWdlbnRlLCBlc3RvIG5vIGFmZWN0YXLDoSBuaSBsYSB2YWxpZGV6IG5pIGxhIGFwbGljYWJpbGlkYWQgZGVsIHJlc3RvIGRlIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEgeSwgc2luIGFjY2nDs24gYWRpY2lvbmFsIHBvciBwYXJ0ZSBkZSBsb3Mgc3VqZXRvcyBkZSBlc3RlIGFjdWVyZG8sIGFxdcOpbGxhIHNlIGVudGVuZGVyw6EgcmVmb3JtYWRhIGxvIG3DrW5pbW8gbmVjZXNhcmlvIHBhcmEgaGFjZXIgcXVlIGRpY2hhIGRpc3Bvc2ljacOzbiBzZWEgdsOhbGlkYSB5IGV4aWdpYmxlLgpjLiBOaW5nw7puIHTDqXJtaW5vIG8gZGlzcG9zaWNpw7NuIGRlIGVzdGEgTGljZW5jaWEgc2UgZXN0aW1hcsOhIHJlbnVuY2lhZGEgeSBuaW5ndW5hIHZpb2xhY2nDs24gZGUgZWxsYSBzZXLDoSBjb25zZW50aWRhIGEgbWVub3MgcXVlIGVzYSByZW51bmNpYSBvIGNvbnNlbnRpbWllbnRvIHNlYSBvdG9yZ2FkbyBwb3IgZXNjcml0byB5IGZpcm1hZG8gcG9yIGxhIHBhcnRlIHF1ZSByZW51bmNpZSBvIGNvbnNpZW50YS4KZC4gRXN0YSBMaWNlbmNpYSByZWZsZWphIGVsIGFjdWVyZG8gcGxlbm8gZW50cmUgbGFzIHBhcnRlcyByZXNwZWN0byBhIGxhIE9icmEgYXF1w60gbGljZW5jaWFkYS4gTm8gaGF5IGFycmVnbG9zLCBhY3VlcmRvcyBvIGRlY2xhcmFjaW9uZXMgcmVzcGVjdG8gYSBsYSBPYnJhIHF1ZSBubyBlc3TDqW4gZXNwZWNpZmljYWRvcyBlbiBlc3RlIGRvY3VtZW50by4gRWwgTGljZW5jaWFudGUgbm8gc2UgdmVyw6EgbGltaXRhZG8gcG9yIG5pbmd1bmEgZGlzcG9zaWNpw7NuIGFkaWNpb25hbCBxdWUgcHVlZGEgc3VyZ2lyIGVuIGFsZ3VuYSBjb211bmljYWNpw7NuIGVtYW5hZGEgZGUgVXN0ZWQuIEVzdGEgTGljZW5jaWEgbm8gcHVlZGUgc2VyIG1vZGlmaWNhZGEgc2luIGVsIGNvbnNlbnRpbWllbnRvIG11dHVvIHBvciBlc2NyaXRvIGRlbCBMaWNlbmNpYW50ZSB5IFVzdGVkLgo=

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