! "#!$ % #!# &#! ## % %# % ' #% % % % !! () *+,-.,,/ 0 1 0 ! 2 34 .,,/ $ &! 5 # ; #! ( F 5# #(! L 6 #(! ## % #! % ! ! L 7 ! L . 7# %8 ! ! > / 5% ! ! @ 9 &(# ! @ ! @ 6 :! % # ! $$ 3%#5 # % ; (# ! ! $0 <# = $; #%&8 $F %# 0$ ( 0F % ;$ 5 ;; 6 <% &!78 ;F " ;@ "# $ ! ! :>: 3: 36 ;@ F@ Dedicatoria A mis padres Carlos y Liduvina a mi esposa Susana a mis hijas Susana Paola y Diana Carolina así como a todos mis hermanos y cuñados por la ayuda y el apoyo constante que me brindaron en todo momento para alcanzar esta gran meta trazada que significa lograr mi segunda especialización como gastroenterólogo %&' ()*+* , - ./* *" % $ ! "#!$ % #!# &#! ## % %# % ' #% % % % !! () *+,-.,,/ 0 %&' ()*+* , - ./* *" % &! 5 # &! 5 # Mi más sincero agradecimiento: 1 '+ ! "& & **'+" " ).+2" *" )3 1 4. +.+" " "" ' "+ 4'' .' *.++* 1 *+ "+ .+* +2" ( 5 " 6 &6 /)++ ".*+ 3. '+ 4*+2" Mi profundo agradecimiento a los Drs. 1 ! * '7" 8+"9! 1 ! +& *+": . 1 ! "+ : 8" 1 ! "( ": +: 1 ! ) + *5 por su ayuda en la formulación, ejecución y culminación de la presente tesis. A todo el personal del servicio de gastroenterología por su colaboración desinteresada, brindándome las facilidades necesarias en la elaboración del presente trabajo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Mosca S, Magnes G, Martino R, et al, Endoscopic management of foreign bodies in the upper gastrointestinal tract: report on a series of 414 adult patients. Endoscopy, 2001; 33(8): 692 – 696. Martinez L, Rivas S, Hernandez F, et al., Aggressive conservative treatment of esophagealperforationsin children. J. Pediatirc Surg. 2003; 38(5): 685 – 689. Steven T, Weiland M.D. Michael J. et al. Conservative management of ingested Foreign Bodies. Journal of Gastrointestinal Surgery. 2002; 6: 496 – 500. %&' ()*+* , - ./* *" % ;L ! "#!$ % #!# &#! ## % %# % ' #% % % % !! () *+,-.,,/ ;> %&' ()*+* , - ./* *" % " " " :: 0 : G 3 >:H :: 1 :: : ' : H *+,-.,,/ %&' ()*+* , - ./* *" % ;@ ! "#!$ % #!# &#! ## % %# % ' #% % % % !! () *+,-.,,/ :6 ! , ! ! "#!$ % #!# &#! ## % D*+, 2 .,,/F ! C 3!# DEF . *+"*+" $?F @< . *+"*+" Q3 L J $$0 $?? ! ,. 3! !# ( ! "#!$ % #!# &#! ## % %# D! *+, 25I .,,/F <? %&' ()*+* , - ./* *" % " $ C 3!# DEF $@>? G $@>< $@>F G $@>@ $@@? G $@@< $@@F - $@@@ 0??? 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