<?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>0864-2125</journal-id>
<journal-title><![CDATA[Revista Cubana de Medicina General Integral]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Med Gen Integr]]></abbrev-journal-title>
<issn>0864-2125</issn>
<publisher>
<publisher-name><![CDATA[ECIMED]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0864-21252022000100020</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Colitis ulcerosa en adolescente]]></article-title>
<article-title xml:lang="en"><![CDATA[An Adolescent with Ulcerative Colitis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[del Cisne Ontaneda Cueva]]></surname>
<given-names><![CDATA[Karen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ontaneda Cueva]]></surname>
<given-names><![CDATA[Jorge Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Técnica Particular de Loja  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro de salud El Ingenio  ]]></institution>
<addr-line><![CDATA[Espíndola Loja]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2022</year>
</pub-date>
<volume>38</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0864-21252022000100020&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0864-21252022000100020&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0864-21252022000100020&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La colitis ulcerosa es una enfermedad inflamatoria intestinal de etiología multifactorial, que afecta principalmente al colon y al recto. Sus síntomas cardinales son diarrea crónica, rectorragia y dolor abdominal en cuadros severos. Su curso se caracteriza por periodos de remisión y de actividad llamados brotes, aunque en una menor proporción puede mostrar una actividad continua. Cuando afecta el recto, el colon izquierdo o más zonas se denomina pancolitis. La colonoscopia con biopsias múltiples es imprescindible para confirmar el diagnóstico y valorar la extensión de la enfermedad.  Objetivo:  Remarcar y promover el cuadro clínico que permita la sospecha diagnóstica de la colitis ulcerosa en el primer nivel de atención.  Caso clínico: Paciente de 19 años de edad con antecedentes de diarrea crónica sanguinolenta, refractaria a varios tratamientos, que remitió por sí misma y que posteriormente recidiva con mayor severidad, lo que hace sospechar de una etiología atípica: colitis ulcerosa.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) of multifactorial etiology that affects the colon and rectum. Its cardinal symptoms are diarrhea, rectal bleeding and abdominal pain(in severe cases). In its course alternate periods of remission and activity (flares), although in a minority it has continuous activity. The extension may affect the rectum, the left colon or even more zones (pancolitis). Colonoscopy with multiples biopsies is essential to confirm diagnosis and evaluate the extension of the disease.  Objective:  To publicize the clinical picture that allows the diagnostic suspicion of ulcerative colitis at the first level of care.  Clinical case: We report a clinical case of a patient of 19 years old with a history of chronic bloody diarrhea refractory to various treatments, which remitted itself and later relapsed more severely, making suspicious of an atypical etiology: ulcerative colitis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[enfermedad inflamatoria intestinal]]></kwd>
<kwd lng="es"><![CDATA[diarrea crónica]]></kwd>
<kwd lng="es"><![CDATA[colitis ulcerosa]]></kwd>
<kwd lng="en"><![CDATA[Inflammatory bowel disease]]></kwd>
<kwd lng="en"><![CDATA[chronic diarrhea]]></kwd>
<kwd lng="en"><![CDATA[ulcerative colitis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barrerio-de Acosta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Colitis Ulcerosa - Actualización]]></article-title>
<source><![CDATA[Medicine: Programa de Formación Médica Continuada Acreditado]]></source>
<year>2016</year>
<volume>12</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>227-41</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peppercorn]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cheifetz]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<source><![CDATA[Definitions, epidemiology, and risk factors for inflammatory bowel disease]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Figueroa]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lubascher]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ibáñez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Kronberg]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Simian]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Flores]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Algoritmos de tratamiento de la colitis ulcerosa desde una experiencia local]]></article-title>
<source><![CDATA[Revista Médica Clínica Las Condes]]></source>
<year>2018</year>
<volume>29</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>570-9</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rubin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ananthakrishnan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Siege]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Sauer]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Long]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ACG Clinical Guideline: Ulcerative Colitis in Adults]]></article-title>
<source><![CDATA[American Journal of Gastroenterology]]></source>
<year>2019</year>
<volume>114</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>384-413</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peppercorn]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Kane]]></surname>
<given-names><![CDATA[SV]]></given-names>
</name>
</person-group>
<source><![CDATA[Clinical manifestations, diagnosis, and prognosis of ulcerative colitis in adults]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedad inflamatoria del intestino]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Cardellach López]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<source><![CDATA[FARRERAS &amp; ROZMAN. Enfermedades del Aparato Digestivo]]></source>
<year>2014</year>
<page-range>101-12</page-range><publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernández-Rocha]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ibáñez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Molina]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Klaassen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Valenzuela]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Candia]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnóstico y manejo de colitis ulcerosa grave: una mirada actualizada]]></article-title>
<source><![CDATA[Revista Médica de Chile]]></source>
<year>2017</year>
<volume>145</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>75-84</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Garcés]]></surname>
<given-names><![CDATA[Mayorga]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez Vélez]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Dávila Bedoya]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Andrade Zamora]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Carrillo Ubidia]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ordóñez Arce]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiología y comportamiento de la enfermedad inflamatoria intestinal en la población ecuatoriana]]></article-title>
<source><![CDATA[ACTA Gastroenterología Latinoamericana]]></source>
<year>2020</year>
<volume>50</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>20-7</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lichtenstein]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedad inflamatoria intestinal]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Goldman]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Schafer]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[GOLDMAN-CECIL Tratado de Medicina Interna Volumen 1]]></source>
<year>2017</year>
<page-range>935-43</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier Saunders]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bressler]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Marshall]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bernstein]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bitton]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Leontiadis]]></surname>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical practice guidelines for the medical management of nonhospitalized ulcerative colitis: The Toronto consensus]]></article-title>
<source><![CDATA[Gastroenterology]]></source>
<year>2015</year>
<volume>148</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1035-58</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Song]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
<name>
<surname><![CDATA[Hyoung]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[GU]]></given-names>
</name>
<name>
<surname><![CDATA[Seo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hwang]]></surname>
<given-names><![CDATA[SW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical characteristics and long&#8208;term prognosis of elderly onset ulcerative colitis]]></article-title>
<source><![CDATA[Journal of Gastroenterology and Hepatology]]></source>
<year>2017</year>
<volume>33</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Melmed]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Targan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Crohn&#8217;s disease: clinical manifestations and management]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Podolsky]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kalloo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Camilleri]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Shanahan]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Fitz]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<source><![CDATA[Yamada&#8217;s Textbook of Gastroenterology]]></source>
<year>2016</year>
<page-range>1418-59</page-range><publisher-loc><![CDATA[Chichester ]]></publisher-loc>
<publisher-name><![CDATA[Wiley Blackwell]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cordero Bernabé]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Oliver Galera]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Alamillo Sanz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez López-Tello]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Amebiasis, giardiasis y tricomoniasis]]></article-title>
<source><![CDATA[Medicine: Programa de Formación Médica Continuada Acreditado]]></source>
<year>2014</year>
<volume>11</volume>
<numero>54</numero>
<issue>54</issue>
<page-range>3181-93</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[López-Vélez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Norman]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Amebiasis - Infecciones causadas por amebas de vida libre]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Cardellach López]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<source><![CDATA[FARRERAS &amp; ROZMAN Medicina Interna Volumen II]]></source>
<year>2016</year>
<page-range>2239-43</page-range><publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Libutti]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Saltz]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Willett]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Levine]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cancer of the colon]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[DeVita]]></surname>
<given-names><![CDATA[VJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lawrence]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenberg]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Devita, Hellman, and Rosenberg&#8217;s Cancer: Principles &amp; Practice of Oncology]]></source>
<year>2015</year>
<page-range>768-813</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Wolters Kluwer Health]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lamarca Lete]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Molina Villaverde]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[López González]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Álvarez-Mon Soto]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cáncer colorrectal. Medicine]]></article-title>
<source><![CDATA[Programa de Formación Médica Continuada Acreditado]]></source>
<year>2013</year>
<volume>11</volume>
<numero>25</numero>
<issue>25</issue>
<page-range>1519-25</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Friedman]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Blumberg]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedad inflamatoria intestinal]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Kasper]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Fauci]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hauser]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Longo]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Jameson]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Loscalzo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[HARRISON. Principios de Medicina Interna]]></source>
<year>2018</year>
<edition>20</edition>
<page-range>2258-76</page-range><publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[McGraw Hill]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Derikx]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Dieleman]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Hoentjen]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Probiotics and prebiotics in ulcerative colitis]]></article-title>
<source><![CDATA[Best Practice &amp; Research Clinical Gastroenterology]]></source>
<year>2016</year>
<volume>30</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>55-71</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
