Manejo endoscopico de cuerpos extraños en el tracto

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Dedicatoria A mis padres Carlos y Liduvina a mi esposa Susana a mis hijas Susana Paola y
Diana Carolina así como a todos mis hermanos y cuñados por la ayuda y el apoyo constante
que me brindaron en todo momento para alcanzar esta gran meta trazada que significa lograr
mi segunda especialización como gastroenterólogo
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Mi más sincero agradecimiento:
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Mi profundo agradecimiento a los Drs.
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por su ayuda en la formulación, ejecución y culminación de la presente tesis.
A todo el personal del servicio de gastroenterología por su colaboración desinteresada,
brindándome las facilidades necesarias en la elaboración del presente trabajo
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