CHALLENGES IN THE SURGICAL MANAGEMENT OF IBD PATIENTS FROM RURAL GREECE papaelestav@gmail.com

 

CHALLENGES IN THE SURGICAL MANAGEMENT OF IBD PATIENTS FROM RURAL GREECE

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Dimitrios Manganas dmanganas@gmail.com General Hospital of Athens "Evaggelismos'' 2nd Surgical Department Athens Greece

Greece

Oral or Poster

Geographic inequities in healthcare access for patients with inflammatory bowel disease (IBD) contribute to delays in diagnosis, inadequate follow-up, and poorer outcomes. Patients living in rural and remote areas often lack regular gastroenterological evaluations and experience higher hospitalization rates compared to those in urban centers. Greece’s multi-insular geography further exacerbates these disparities.

This study presents the challenges encountered during the surgical management of three IBD patients from rural Greece, highlighting the urgent need for multidisciplinary IBD teams

All three patients were initially managed by local gastroenterologists near their residences and were later referred to our department for surgical intervention and continued hospitalization. The first case involves a 58-year-old female diagnosed with ulcerative colitis in 2018, who underwent three-stage surgery. Post-ileostomy restoration, she developed a perianal abscess, and delayed endoscopy revealed pouchitis. The second case is a 45-year-old male with Crohn’s disease who underwent emergency surgery at a rural hospital and was transferred to our unit with prolonged fever and malnutrition. The third case is a 40-year-old female with a history of subtotal colectomy, who was unable to undergo regular endoscopies due to financial barriers.

IBD patients require coordinated care from a team of specialists, including gastroenterologists, surgeons, and dietitians. Given the growing range of treatment options and the importance of accurate preoperative assessment, establishing multidisciplinary IBD teams is essential. Special attention must be given to patients in rural areas by improving access to specialized care and reinforcing the importance of regular follow-up.