Rare Post-Cesarean Complication Reported in Mogadishu

Rare Post-Cesarean Complication Reported in Mogadishu

Doctors in Mogadishu have reported a rare complication following a cesarean delivery, shedding light on a condition that is seldom diagnosed in Somalia. A 30-year-old woman developed endometrial tissue inside her surgical scar, causing cyclical pain for more than a year. This condition, known as scar endometriosis, is often mistaken for hernias or post-operative infections, which can delay proper treatment.

Scar endometriosis happens when tissue that normally lines the uterus grows in a surgical incision, responding to hormonal changes every month. Studies worldwide estimate its occurrence after cesarean deliveries at 0.03% to 1.7%, but the true number is likely higher in low-resource settings due to underdiagnosis.

In this case, the patient noticed a painful nodule on her cesarean scar, which became more severe during menstruation. Ultrasound imaging confirmed the lesion, and surgical excision successfully removed the endometrial tissue. The patient recovered completely and remained symptom-free at follow-up.

The report emphasizes that increasing cesarean rates in Somalia make early recognition of rare complications essential. Limited imaging, inconsistent surgical hygiene, and gaps in post-operative care contribute to missed diagnoses. Experts advise that wide surgical excision is the most effective treatment, while hormone-based therapies often provide only temporary relief.

With cesarean deliveries on the rise, Somali health facilities are encouraged to strengthen surgical protocols, improve diagnostic training, and raise awareness among clinicians to safeguard maternal health and prevent unnecessary suffering.