<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-9957</journal-id>
<journal-title><![CDATA[Revista colombiana de Gastroenterología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Col Gastroenterol]]></abbrev-journal-title>
<issn>0120-9957</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Gastroenterología  ]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-99572019000300231</article-id>
<article-id pub-id-type="doi">10.22516/25007440.449</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Papel de la ecoendoscopia en la evaluación de la dispepsia no investigada en una población colombiana]]></article-title>
<article-title xml:lang="en"><![CDATA[The role of endoscopic ultrasound in evaluating patients with dyspepsia in a Colombian population]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez Zuleta]]></surname>
<given-names><![CDATA[Martín A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Otero Regino]]></surname>
<given-names><![CDATA[William]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruíz Morales]]></surname>
<given-names><![CDATA[Óscar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Nacional de Colombia  ]]></institution>
<addr-line><![CDATA[Bogotá D. C]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Colombia  ]]></institution>
<addr-line><![CDATA[Bogotá D. C]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad San Martín  ]]></institution>
<addr-line><![CDATA[Bogotá D. C]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2019</year>
</pub-date>
<volume>34</volume>
<numero>3</numero>
<fpage>231</fpage>
<lpage>236</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-99572019000300231&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-99572019000300231&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-99572019000300231&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La dispepsia se define como un dolor o molestia abdominal superior que se considera originado en el tracto gastrointestinal superior. Muchas enfermedades y condiciones clínicas pueden producir dispepsia como la úlcera péptica, cáncer gástrico o esofágico, medicamentos, litiasis biliar, pancreatitis, cáncer de páncreas, entre otras. Por una parte, tradicionalmente la dispepsia solo se evalúa con la endoscopia digestiva y su producción solo es del 27 %. Por otra parte, la ecoendoscopia (ECE), al combinar una imagen endoscópica y una imagen ecográfica, podría ampliar el rango diagnóstico al detectar más causas de dispepsia que puedan ayudar a tratar al paciente de manera más oportuna.  Objetivo: evaluar si la ECE aumenta el rendimiento diagnóstico que tiene la endoscopia (27 % en nuestro medio) en el enfoque inicial de la dispepsia no investigada (DPNI).  Materiales y métodos: estudio prospectivo, de prevalencia analítica en pacientes adultos con DPNI, que consultaron a una institución universitaria de Colombia. Los pacientes incluidos consultaron a la unidad de gastroenterología durante el período comprendido entre enero a octubre del 2016 y se programaron para endoscopia digestiva alta (EDA). Bajo sedación guiada por anestesiólogo primero se realizó la fase endoscópica evaluando el esófago, estómago y duodeno; después se realizó la fase ecográfica y se inició el examen de manera retrógrada evaluándose el páncreas en su totalidad, la vía biliar extrahepática, la vesícula biliar, el tronco celíaco, el lóbulo izquierdo del hígado y la región mediastinal. Todas las anormalidades se anotaban en el formulario de ingreso del paciente.  Resultados: En total se incluyeron a 60 pacientes, de los cuales el 65 % son de sexo femenino con un promedio de edad de 40,8 (desviación estándar: 12,5). Los hallazgos en la fase endoscópica de la ECE fueron principalmente gastritis crónica en 43 pacientes (71,6 %), el resto tenía una lesión estructural (17 pacientes): esofagitis en 5 (8,3 %), úlcera gástrica en 2 (3,3 %), úlcera duodenal en 5 (8,3 %), cáncer gástrico en 4 (6,6 %) y lesión subepitelial gástrica (GIST) en 1 (1,6 %). Los hallazgos en la fase ecográfica de la ECE fueron colelitiasis en 11 (18,3 %), coledocolitiasis en 1 (1,6 %) y pancreatitis crónica en 5 (8,3 %). Aunque solo el 28,3 % (17) de los pacientes con dispepsia tuvo un hallazgo estructural en la fase endoscópica, 18 pacientes (30 %) presentaron algún hallazgo positivo en la fase ecográfica, es decir que el rendimiento subió a un 58,3 % (p &lt;0,001).  Conclusión:  este estudio, aunque pequeño, sugiere que la ECE como método inicial de enfoque en la evaluación de la dispepsia podría llegar a ser útil dado que aumenta el rendimiento diagnóstico en este grupo de pacientes, pasando de un 28,3 % a 58,3 %, lo cual es muy significativo si se tiene en cuenta que estos pacientes con dispepsia y endoscopia negativa usualmente se catalogan como funcionales y solo se les formula medicamentos. Sin embargo, se deben reconocer las fallas metodológicas del estudio y consideramos que es una exploración inicial y deben plantearse estudios más grandes y controlados para confirmar este trabajo; además, se debe tener en cuenta el costo del examen, que es mucho mayor que el de la EDA.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Dyspepsia is defined as upper abdominal pain or discomfort that is considered to originate in the upper gastrointestinal tract. Many diseases and clinical conditions can cause dyspepsia. Among others, they include peptic ulcers, gastric and esophageal cancer, medications, biliary lithiasis, pancreatitis, and pancreatic cancer. Traditionally, dyspepsia is only evaluated with digestive endoscopy whose diagnostic yield is only 27%. On the other hand, endoscopic ultrasound combines an endoscopic image and an ultrasound image thereby potentially broadening diagnostic range to detect more of the causes of dyspepsia allowing treatment of patients in a timelier manner.  Objective: To evaluate whether endoscopic ultrasound increases the diagnostic yield of endoscopy (27% in our environment) in the initial approach to previously unstudied dyspepsia.  Materials and methods: This is a prospective study of analytical prevalence in adult patients with previously unstudied dyspepsia who were examined at a university institution in Colombia. The patients included were seen in the gastroenterology unit from January to October 2016 and underwent upper digestive endoscopy and endoscopic ultrasound. Under anesthesiologist-guided sedation, the stomach and duodenal esophagus were first evaluated endoscopically. Then retrograde endoscopic ultrasound was used to evaluate the pancreas in its entirety, the extra hepatic bile duct, the gallbladder, the celiac trunk, the left lobe of the liver and the mediastinal region. All abnormalities were noted on the patient&#8217;s admission form.  Results: In total we included 60 patients of whom 65% were female and whose average age of was 40.8 years (SD: 12.5). The findings in the endoscopic phase of the endoscopic ultrasound were mainly chronic Gastritis 43 patients (71.6%), the rest had a structural lesion (17 patients): esophagitis 5 (8.3%), gastric ulcer 2 (3.3%), duodenal ulcer 5 (8.3%), gastric cancer, 4 (6.6%), gastric subepithelial lesion (GIST) 1 (1.6%). In the endoscopy phase, we found 11 cases of cholelithiasis (18.3%), one case of choledocholithiasis (1.6%), and five cases of chronic pancreatitis (8.3%). Only 17 patients of these patients (28.3%) had a structural finding in the endoscopy phase, but 18 additional patients (30%) had some positive finding in the ultrasound phase. In other words, the diagnostic yield rose to 58.3% (p &lt; 0.001).  Conclusion: Although this study&#8217;s sample size is small, it suggests that using endoscopic ultrasound in the initial evaluation of dyspepsia could be useful since it increased diagnostic yield in this group of patients from 28.3 to 58.3%. This is very significant because patients with dyspepsia and negative endoscopy are usually classified as functional and only treated with medications. However, in recognition of the methodological limitations of this study, it should be considered an initial exploration. Larger, controlled studies should be considered to confirm this work. Another factor that should be considered is the cost of endoscopic ultrasound which is much higher than the upper digestive endoscopy.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Ecoendoscopia]]></kwd>
<kwd lng="es"><![CDATA[evaluación]]></kwd>
<kwd lng="es"><![CDATA[dispepsia]]></kwd>
<kwd lng="es"><![CDATA[cáncer gástrico]]></kwd>
<kwd lng="en"><![CDATA[Endoscopic ultrasound]]></kwd>
<kwd lng="en"><![CDATA[evaluation]]></kwd>
<kwd lng="en"><![CDATA[dyspepsia]]></kwd>
<kwd lng="en"><![CDATA[gastric cancer]]></kwd>
</kwd-group>
</article-meta>
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