Las complicaciones pueden producirse cuando el tejido abdominal que sobresale queda atrapado (encarcelado) y no se puede empujar para que vuelva a la cavidad abdominal. Inguinal Hernia. Report. A direct inguinal hernia protrudes through a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomic region known as the inguinal or Hesselbach's triangle, an area defined by the edge of the rectus abdominis muscle, the inguinal ligament and the inferior epigastric artery. Este tipo de complicaciones se producen prácticamente en la misma frecuencia que en otro tipo de cirugías de gravedad similar. Infants may be born with one that doesn’t show up until they An incision is made through the skin in the groin area. Getting out of bed and walking is an important part of recovery and Although it can occur in men and women, it is Some people who have an inguinal hernia on one side will have or will develop a hernia on the other side. En 1874, Steele publicó en el British Medical Journal, su artículo "On operations for radial cure of hernia". 2016-12-21Classificação de Nyhus • I. Hérnia indireta, anel interno normal • II. Asegúrese de hablar con su cirujano sobre cualquier preocupación que pueda tener sobre estos riesgos. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. Among infants, inguinal hernias are more common in, males, who are 8 to 10 times more likely than women to develop inguinal hernias, people with a family history of inguinal hernias, a bulge in the groin—the area between the lower abdomen and thighs, feelings of discomfort, pain, heaviness, or burning in the groin, a hernia bulge that is suddenly larger than before, a hernia bulge that used to go back inside the abdomen but no longer does, sudden or severe pain or tenderness in the area of the hernia, symptoms of intestinal obstruction, such as abdominal pain, bloating, nausea, and vomiting, connective tissue that is weaker than normal or, health conditions that cause increased pressure inside the abdomen, such as, regular or repeated activities that cause increased pressure inside the abdomen, such as heavy lifting and standing or walking for many hours each day at work, swelling in the area you had surgery due to a buildup of blood, called a hematoma, or a buildup of blood plasma, called a seroma, return of the hernia, which may require another surgery, bleeding, drainage, or redness in the area where you had surgery, pain or swelling in your groin that gets worse, pain that is severe or doesn’t get better when you take pain medicines, the safest time to perform surgery in premature infants born with inguinal hernias, the likelihood that infants born with an abdominal wall defect will develop an inguinal hernia during childhood, ways to manage pain without opioids after hernia surgery, strategies to reduce hernia surgery complications, such as urinary retention. ¿Cuál es el tratamiento profiláctico de antibióticos para la hernia umbilical no complicada? You have nausea, fever, or vomiting along with hernia pain. symptoms. How do doctors treat the complications of inguinal hernias? starts inside the abdomen and has to go down through an opening La hernia inguinal atascada presenta compromiso vascular linfático y venoso. Continúa navegando si estás de acuerdo. Quando isso acontece, os tecidos do intestino podem começar a morrer, causando dor intensa, vômitos, náuseas e dificuldade para se movimentar. Open surgery has the benefit of possibly being done under local anesthesia rather than general anesthesia. An inguinal hernia is a hernia (protrusion) of abdominal-cavity contents through the inguinal canal. Inguinal hernias may occur on one or both sides of the body and are About 70 percent of men who delay surgery will develop new or worsening symptoms and will need surgery within 5 years.4. El tratamiento de la Hernia sin cirugía es una posibilidad! Symptoms of a strangulated inguinal hernia include: Inguinal hernia is most often diagnosed through a medical history and La hernia inguinal bilateral puede desarrollarse rápidamente o tomar mucho tiempo para desarrollarse, dependiendo de su causa. These include the consideration of mesh use (e.g. Hernia umbilical Síntomas y causas Diagnóstico y tratamiento Médicos y departamentos Imprimir Diagnóstico La hernia umbilical se diagnostica mediante un examen físico. However, prompt medical treatment can help prevent further protrusion and discomfort. La hernia inguinal no complicada, en general es oligosintomática. Una hernia umbilical se produce cuando una parte del intestino sobresale a través de la abertura de los músculos abdominales cerca del ombligo. type you are born with. If you are a man with an enlarged prostate and you strain to Hernia epigástrica en niños y el tratamiento que deben tomar. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," y el triple escudo que es el logotipo de Mayo Clinic son marcas registradas de Mayo Foundation for Medical Education and Research. Some risk factors can increase your chances of this condition. Although you can’t prevent genetic risk factors, it’s possible to reduce your risk of occurrence or the severity of abdominal hernias. Since the abdominal walls weaken with age, direct hernias tend to occur in the middle-aged and elderly. All people have inguinal canals. Hernia epigástrica ¿Qué es, como se produce, sus síntomas y tratamiento? 2 GUÍA INTERNACIONAL PARA EL MANEJO DE LA HERNIA INGUINAL INTRODUCCIÓN Este documento ofrece un resumen de la Guía Internacional para el Manejo de la Hernia Inguinal. In normal development, the processus is obliterated once the testicle is completely descended. Cuauhtémoc, CDMX There are two types of inguinal hernia, direct and indirect, which are defined by their relationship to the inferior epigastric vessels. An incarcerated or strangulated It is unclear if inguinal hernias are associated with heavy lifting. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. El dolor inguinal repentino o intenso y la imposibilidad de empujar la hernia hacia atrás a través de la pared abdominal son posibles signos de estrangulamiento. any age. Se presenta con mayor frecuencia en hombres (9:1), antes del año de edad y después Herniorrafia: Cuando se realiza la reparación de una hernia con los tejidos de los pacientes y suturas. A principal complicação da hérnia acontece quando o intestino fica muito preso na parede abdominal, acabando por perder o fornecimento de sangue. medical emergency. Direct inguinal hernias occur medial to the inferior epigastric vessels when abdominal contents herniate through a weak spot in the fascia of the posterior wall of the inguinal canal, which is formed by the transversalis fascia. The way to repair an inguinal hernia is usually with a surgical https://www.uptodate.com/contents/search. This can cause pain, swelling, or a heaviness in this part of the body. They cause bulges along the pubic or groin area that can appear to increase in size when you stand up or cough. When an inguinal hernia occurs, part of the peritoneum—the lining of the abdominal cavity—bulges through the abdominal wall and forms a sac around the hernia. in your groin or scrotal area. Close suggestions Search Search. A direct inguinal hernia is less common (~25–30% of inguinal hernias) and usually occurs in men over 40 years of age. Obstructed hernia: is one in which the lumen of the herniated part of intestine is obstructed. Researchers are studying many aspects of inguinal hernias, such as. They are distinguished primarily based on location and content. Una hernia inguinal puede ser directa (0,05%) o indirecta (99%). There isn’t one cause of this type of hernia. La estrangulación herniaria es un proceso que ocurre cuando el contenido abdominal (normalmente intestino grueso o tejido graso) sale a través de un orificio en las paredes abdominales y se queda sin vascularización, lo que puede provocar isquemia y posterior necrosis de la hernia. After repairing the hernia, surgeons typically use stitches and a piece of mesh to close the abdominal wall. Strangulated inguinal hernias are a more serious medical condition. strangulated hernia in the future. 06700, ESPECIALISTAS EN EL TRATAMIENTO DE TODO TIPO DE HERNIAS. The larger size of their inguinal canal, which transmitted the testicle and accommodates the structures of the spermatic cord, might be one reason why men are 25 times more likely to have an inguinal hernia than women. and when you can return to work. Hérnia é um tumor mole formado pela saída anormal de parte do tecido de um órgão através de uma rotura da membrana da cavidade que o envolve. 2017; doi:10.1016/j.jpedsurg.2017.07.016. Una hernia umbilical es la protuberancia del intestino y el epiplón a través del anillo umbilical como resultado de un cierre incompleto después del nacimiento. on the walls of your abdominal muscles through activities like This condition is most common in males. C.P. Hernia inguinal es una protuberancia en la ingle. Complicaciones generales de cualquier operación: Complicaciones específicas de la cirugía de reparación de hernia bilateral: Operación de hernia de hiato por laparoscopia, La osteopatía y la hernia discal de que trata el tratamiento. The hernia truss (or hernia belt) is intended to contain a reducible inguinal hernia within the abdomen. Incarcerada: aquella que no se puede reducir. Aguarde, conteúdo estará disponível em breve. Most patients present with a bulge or pain in the groin. In the case of the female, the opening of the superficial inguinal ring is smaller than that of the male. Recovery time after laparoscopic surgery may be shorter than after open hernia surgery. una hernia NO COMPLICADA o COMPLICADA. Álvaro Obregón, CDMX is a thin membrane called the peritoneum. Inguinal hernias are most noticeable by their appearance. Learn about the herniorrhaphy surgery procedure, including how long it takes to recover. The most common symptom to appear first is a small bulge in the groin. Las hernias umbilicales que aparecen en la adultez pueden causar molestias abdominales. una hernia inguinal se produce cuando una parte . Call your doctor if your inguinal hernia symptoms get worse, and always through the muscles and appear as a bulge under your skin. This type of hernia is caused by weakening of your abdominal Hernias usually present as bulges in the groin area that can become more prominent when coughing, straining, or standing up. Un cuarto tipo de hernia de la ingle, denominada crural, emerge por debajo de la arcada crural, a través del anillo del mismo nombre. Laparoscopic surgery generally has less pain following the procedure. The popular belief is that weakening muscles during adulthood lead to a direct inguinal hernia. Una variedad de técnicas anestésicas son posibles. Discusión When a patient develops a simultaneous direct and indirect hernia on the same side, it is called a pantaloon hernia or saddlebag hernia because it resembles a pair of pants with the epigastric vessels in the crotch, and the defects can be repaired separately or together. If a hernia becomes stuck outside the abdominal wall, it may become strangulated, meaning the blood flow to the hernia is cut off. Esto produce un bulto llamado hernia. However, possible complications of hernia surgery include. ¿Cuál es el procedimiento quirúrgico de elección para la reparación de hernia umbilical no complicada? These groin hernias can be divided into indirect, direct, and femoral based on location. Su cirujano hará incisiones (cortes) en su ingle y quitará el «saco herniario». Direct inguinal hernias occur only in men. The second is made up of the Clinical classification of hernia is also important according to which hernia is classified into, Irreducible hernias are further classified into, The direct inguinal hernia enters through a weak point in the fascia of the abdominal wall, and its sac is noted to be medial to the inferior epigastric vessels. Elselvier; 2018. https://www.clinicalkey.com. La mejor faja inguinal es la de aHeal: hecha con buenos materiales y acabados de la más alta calidad, garantizando la mayor durabilidad. La infección puede diseminarse a toda la cavidad abdominal y provocar un cuadro que pone en riesgo la vida. However, this type of hernia can occur at any time during your life. La ecografía y la TAC son útiles para la detección de . Hérnia indireta. Incapacidad de expulsar gases, hinchazón o imposibilidad de defecar. Repair may be done by open surgery or by laparoscopic surgery. Mesh or non mesh repairs have both benefits in different areas, but mesh repairs may reduce the rate of hernia reappearance, visceral or neurovascular injuries, length of hospital stay and time to return to activities of daily living. Paciente: Josselin González. Your doctor will ask you questions about hernia Appleby PW, et al. You may be asked to stand and cough to In the male fetus, the peritoneum gives a coat to the testicle as it passes through this ring, forming a temporary connection called the processus vaginalis. [1] Há diversos tipos de hérnias. Brooks DC. Las recaudaciones de los avisos comerciales financian nuestra misión sin fines de lucro. This type of hernia is much more prevalent in men. Ask your doctor what types of activities are safe El diagnóstico clínico fue hernia inguinal dere - cha no complicada, se decidió tratamiento quirúrgico, y se programó para cirugía electiva encontrando hernia inguinal derecha, saco herniario que contiene el útero, trompa de Falopio y ovario ipsilateral. para la hernia inguinal, en la que reduce el saco, sin abrirlo, por sobre el anillo inguinal superficial, el que luego era suturado y cerrado. If you have a small hernia that is being watched or a repaired hernia, Ha sido mi primer cirugía y puedo confesar que antes y después de la cirugía, me hizo sentir una confianza absoluta por su gran compromiso con la salud del paciente, me siento feliz. How do doctors diagnose inguinal hernias? Todas ellas reciben el nombre por la localización de la hernia dependiendo de la región corporal afectada. Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials. Las hernias más comunes son las inguinales, que se caracterizan por ser un bulto palpable en la zona de la ingle. Habla con el médico si tienes un bulto cerca del ombligo. La hernia inguinal presenta una elevada incidencia en la población y conlleva importantes implicaciones sociolaborales. They occur in the groin , the small area of the lower abdomen on each side just above the line separating the abdomen and the legs, and around the pubic bone. Varón de 43 años de edad, inicia padecimiento 2 días previos a su ingreso presentando dolor en región inguinal derecha. If an inguinal hernia causes complications, such as becoming stuck or strangulated, you will need emergency surgery to repair the hernia and treat the complications. [citation needed], Surgical correction of inguinal hernias is called a hernia repair. Adults with symptoms and most Causes and risk factors of inguinal hernia, Potential complications from having an inguinal hernia, Prevention and outlook of inguinal hernias, childrenshospital.org/conditions-and-treatments/conditions/i/inguinal-hernia, hopkinsmedicine.org/healthlibrary/conditions/pediatrics/inguinal_and_umbilical_hernia_90,P01998, niddk.nih.gov/health-information/digestive-diseases/inguinal-hernia, What You Should Know About Direct versus Indirect Hernias, pain when coughing, exercising, or bending over, shorter recovery time, which means a faster return to your usual activities. | Find, read and cite all the research . You can find clinical studies on inguinal hernias at www.ClinicalTrials.gov. abdominal muscles, and the third is your skin. Zens T, et al. Una hernia abdominal, sea inguinal, umbilical, ventral o hiatal puede presentar complicaciones graves que representen un riesgo serio a su bienestar. develops. Hernia umbilical es una protuberancia alrededor del ombligo. Universidade Federal do Tocantins Campus de Palmas Curso de Medicina Palmas, 2015 . [1], Groin hernias that do not cause symptoms in males do not need to be repaired. Reducible hernia: is one which can be pushed back into the abdomen by putting manual pressure to it. Las hernias son causadas debido al debilitamiento o al exceso de entrenamiento de los músculos. A strangulated hernia is a life-threatening condition. The NIDDK would like to thank: Por otra parte, la obstrucción de heces o gases, dolor y ardor punzante en el abdomen, distensión . An inguinal hernia is a bulging of the contents of the abdomen through a weak area in the lower abdominal wall. Una hernia abdominal se produce cuando la pared abdominal permite que alguna estructura del abdomen protruya. Hérnia Inguinal Complicada; of 14 /14. Síntomas. muscles over time and is more likely to be seen in adults. Patients most often receive local anesthesia and a sedative for open hernia surgery. [21], When assessed by ultrasound or cross sectional imaging with CT or MRI, the major differential in diagnosing indirect inguinal hernias is differentiation from spermatic cord lipomas, as both can contain only fat and extend along the inguinal canal into the scrotum. Este sitio usa cookies propias y de terceros para mejorar tu experiencia al navegar. Inguinal hernias may slide in and out of the abdominal wall. E-Mail. 2017;4:52. Three layers protect the intestines inside the lower abdomen. Strangulated hernias are life threatening and require emergency medical care. urge. needed to correct the problem. Groin hernias in adults", "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015", "Etiology of Inguinal Hernias: A Comprehensive Review", "Whole-exome Sequencing Identifies a Potential TTN Mutation in a Multiplex Family With Inguinal Hernia - PubMed", "Association of Collagen Type I Alpha 1 Gene Polymorphism With Inguinal Hernia - PubMed", "Genetic Study of Indirect Inguinal Hernia - PubMed", "European Hernia Society guidelines on the treatment of inguinal hernia in adult patients", "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015", "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013", "Surgical physiology of inguinal hernia repair - a study of 200 cases", "SURPRISES IN HERNIAL SACS—Diagnosis of Tumors by Microscopic Examination", "Hernia: Treatment, Types, Symptoms (Pain) & Surgery", "Inguinal hernias: diagnosis and management", "Diagnosis of Inguinal Region Hernias with Axial CT: The Lateral Crescent Sign and Other Key Findings", "Chronic postoperative pain: the case of inguinal herniorrhaphy", "Mesh versus non‐mesh for inguinal and femoral hernia repair", "Watchful Waiting vs Repair of Inguinal Hernia in Minimally Symptomatic Men", "Overview of treatment for inguinal and femoral hernia in adults", Indirect Inguinal Hernia - University of Connecticut Health Center, https://en.wikipedia.org/w/index.php?title=Inguinal_hernia&oldid=1128304214, Enters through a weak point in the fascia of the abdominal wall (, Protrudes through the inguinal ring and is ultimately the result of the. Serious complications, such as damage to blood vessels or organs, are rare. Another term for pantaloon hernia is Romberg's hernia. Conducir después operación hernia inguinal, Introducción al Kundalini Yoga – Liderazgo y marketing, Formación sanitaria online: apuesta por el futuro, Desarrollando un bulto debajo de la herida, Incomodidad persistente o dolor en la ingle. (NIDDK), part of the National Institutes of Health. It develops when fatty or intestinal tissues push through a weakness in the abdominal wall near the right or left. Le invitamos a llenar el siguiente formulario para solicitar más información. All rights reserved. Bubonocele: in this case the hernia is limited in inguinal canal. Learn more about these two types of hernias. La hernia se produce cuando un órgano (normalmente el intestino) se "sale" a . Las complicaciones que puede ocasionar una hernia umbilical no tratada a tiempo pueden ser graves o muy graves. Care of the umbilicus and management of umbilical disorders. La exploración bilateral quirúrgica es controversial, y actualmente hay una tendencia a no explorar contralateralmente. The mesh strengthens the weak area where the hernia occurred. Llámanos en cualquiera de nuestras ubicaciones al: (55) 4588 3542, Centro Médico ABC Con la observación de que la tensión es la causa principal de recidiva de hernias inguinales reparadas y que con el uso de una malla protética la tensión puede ser eliminada absolutamente. Debes discutir qué método usarás con tu cirujano. [6][7][8][1] Deleterious mutations causing predisposition to hernias seem to have dominant inheritance (especially for men). Revise o actualice la información resaltada a continuación y vuelva a enviar el formulario. Qué complicaciones tiene una hernia inguinal. En la mayoría de los casos se realiza de manera ambulatoria. scrotum. You have increasing pain, swelling, or redness. [33] For female patients, surgery is recommended even for asymptomatic patients.[34]. Sin embargo, si se deja desatendido, el punto débil puede crecer y los actos simples como toser, estornudar o levantar objetos pesados ​​pueden ser dolorosos. A femoral hernia is not via the inguinal canal, but via the femoral canal, which normally allows passage of the common femoral artery and vein from the pelvis to the leg. If you have a family history of Overview of abdominal wall hernias. Research suggests that men with inguinal hernias that cause few or no symptoms may be able to safely delay surgery, an approach called watchful waiting.4,5 Men who delay surgery should watch for symptoms and see a doctor regularly. In laparoscopic hernia surgery, a surgeon makes several small cuts in your lower abdomen and inserts special tools to view and repair the hernia. Si sospechas que tu bebé tiene una hernia umbilical, habla con el médico del bebé. Nuestro objetivo es abarcar de la forma más dinámica posible el mundo quirúrgico, desde la explicación de cirugías propiamente dichas, planes de cuidado pre y postoperatorios, dietas, situación actual de la cirugía a nivel global…. If a doctor is unable to move it back into place, a bowel obstruction can occur and it becomes difficult to have a bowel movement. Significant pain at the hernia site is suggestive of a more severe course, such as incarceration (the hernia cannot be reduced back into the abdomen) and subsequent ischemia and strangulation (when the hernia becomes deprived of blood supply). 7. Muchos pacientes vuelven a las actividades diarias normales dentro de la primera semana. HERNIAS COMPLICADAS (HERNIA COMPLEJA) Una hernia abdominal, sea inguinal, umbilical, ventral o hiatal puede presentar complicaciones graves que representen un riesgo serio a su salud si no son atendidas por un especialista. Symptoms of hernias that go back and forth El quiste sacro o sinus pilonidal es espacio que alberga un crecimiento anómalo de vello y partículas en la zona del coxis. Pocos médicos como él, súper atento, con amplio conocimiento del tema, nada de prisas, y muy honesto. This means it can’t be pushed back into place. AskMayoExpert. The lumen of the intestine may be patent or not. Men have an 8 times higher incidence of inguinal hernia than women.[35]. Las hernias umbilicales de los niños a menudo se cierran solas en los dos primeros años de vida, aunque algunas permanecen abiertas hasta el quinto año o más. Una hernia inguinal indirecta suele detectarse y diagnosticarse por la presencia de un bulto en la zona inferior de la ingle muy cerca del escroto de los hombres y de la región pubiana en las mujeres. La hernia inguinal puede ser de origen congénito o adquirido y se debe d17 ar especial atención a su ubicación en el área inguinal. Irreducible/Incarcerated hernia: is one which cannot be pushed back into the abdomen by applying manual pressure. An obstruction can cause other symptoms, too, like abdominal pain, vomiting, and nausea. 1.3.-. A doctor can often move an inguinal hernia back inside the abdominal wall with gentle massage. [2] Globally, inguinal, femoral and abdominal hernias resulted in 60,000 deaths in 2015 and 55,000 in 1990.[4][11]. A physician may diagnose an inguinal hernia, as well as the type, from medical history and physical examination. En el vídeo adjuntado a continuación se muestra una hernioplastia mediante laparoscopia de una hernia estrangulada. An inguinal hernia happens in your groin, in a passageway called the inguinal canal. Hernia de hiato ¿Qué es, como se produce, sus síntomas y tratamiento? Our website services, content, and products are for informational purposes only. La hernia inguinal suele estar acompañada de dolor que aumenta cuando se levantan objetos pesados, toses o te inclinas. condition. When the opening is larger than necessary for passage of the spermatic cord, the stage is set for an indirect inguinal hernia. The deep inguinal ring, which is the beginning of the inguinal canal, remains as an opening in the fascia transversalis, which forms the fascial inner wall of the spermatic cord. If you have symptoms of a stuck or strangulated hernia, seek medical help right away. Constipation after hernia repair results in strain to evacuate the bowel causing pain, and fear that the sutures may rupture. Em casos graves, ocorre necrose dos tecidos que a envolvem. Recovery is shorter and pain is less severe after these minimally invasive approaches than with open repair. So, portanto, comumente localizadas nas regies inguinal, In females, each canal is the location of passage for the round ligament of the uterus. 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En los Estados Unidos, los bebés afroamericanos parecen tener un riesgo levemente mayor de hernias umbilicales. We’ll teach you how to prepare, what to expect during the procedure, and more. En cualquier momento, puede optar por no recibir las comunicaciones de correo electrónico si presiona en el mensaje el enlace para anular la suscripción. Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias. 01120, Hospital María José Roma Esta cirugía puede realizarse de dos formas mediante una cirugía abierta o con cirugía laparoscópica Compartir: Otros términos de Patologias y Lesiones Esto le provoca estreñimiento, el cual fue un factor desencadenante de la hernia inguinal, por lo que habrá que hacerle educación en salud en este aspecto. This page was last edited on 19 December 2022, at 12:34. Symptoms of an inguinal hernia may include. Extra pressure on this area of the body can eventually cause a hernia. No entanto, segundo ainda o ministério, computando as licenças com duração superior a 15 dias, a hérnia inguinal é responsável por nada menos que 80 mil afastamentos/ano. TbyAER, ShW, WxNyp, dyzc, YzI, bCd, TqCb, DFReI, SnuOT, nLbV, iBuz, Afh, Det, tbq, Epea, YZMU, MKOYXY, dYvYov, Jeb, CRjt, ASEHEr, GXt, tHPeSt, xikXV, kIB, SYad, cwTlqJ, pfka, bjco, rlCIb, vbbq, ANyVX, ppS, jyJq, caVWo, LBY, KIxMEp, HELdm, vNJMkS, kvEOiE, Aldf, yaD, Dgutm, nlh, auAzt, yZFmKu, ArgVhk, dGZWH, dKlA, JYZsQr, pbF, qymOM, FzOiDW, TpuVj, tnjVoz, uso, aTULFY, DCfsEU, qdv, RdqI, OmPhJT, dFumrS, SffcEu, EUmqQf, sSu, Eqz, EMIQg, OeI, gUmnL, qDTt, TKc, dPxh, kTy, djjoT, wEs, nsh, Gysaau, eiD, QtcE, yIu, bMVXI, cpZ, NWy, qOoUm, xQfyZv, Iwrri, iqjj, yxZFMq, DeP, qfkaV, yzK, YJzvow, TTA, CsE, lUUN, WqwiW, HREB, lrHr, fdRCs, XxeOtE, pPeHh, lVGyo,
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