For 11 excruciating months, the injuries persisted.
the
abdomen
A high school student’s issue in Nairobi persisted and worsened.
.
She had undergone a laparoscopic surgery on her pelvis wall to treat endometriosis. The surgery involves
tiny incisions
,
The type that often vanishes within days.
However, for this 17-year-old student, they stayed open, exposed, and seeping.
Medics had
cleaned
and dressed
them
at every hospital visit
Nevertheless, they remained open.
“She underwent several readmissions, often one or two months apart, due to ongoing abdominal discomfort and laparoscopic port sites that failed to heal, accompanied by blood-tinged secretions,” explain Dr. Maryanne Mwangi and Dr. Charles Muteshi, the physicians who cared for her at Aga Khan University Hospital in Nairobi, as detailed in a recent case study.
”
These injuries on the port sites lasted for around 11 months.
At first, the medics
believed it was merely an uncommon side effect of the operation.
T
urn
s
out
,
the wounds were
n
o
t failing to heal
. T
hey were being reopened.
But by whom? The patient consistently
refused to scratch the incision sites
.
E
ndometriosis
is
A debilitating condition characterized by the development of tissue akin to the uterine lining in areas beyond the uterus.
The discomfort frequently intensifies during menstruation, sexual activity, or bowel movements. In certain individuals, this pain may be persistent, occurring constantly rather than only during menstrual cycles.
This is a significant factor for numerous individuals seeking medical assistance.
“She
(the student)
experienced persistent stomach ache along with some ooze coming from the navel,” the report stated.
physicians mention in their report they
published
In the Ajog Global Reports magazine
Both her scholarly pursuits and activities outside of class suffered significantly.
Before
being
diagnos
enrolled at Aga Khan due to endometriosis, the student
had moved between multiple hospitals
for three years
, misdiagnosed and underestimated, even receiving treatment for tuberculosis at some point
, they said
.
The medics counselled her
along with her parents regarding a potential diagnostic laparoscopy for possible endometriosis treatment
,
to which they consented
.
The physicians created small incisions (ports) on the abdominal area and introduced a slender, illuminated instrument equipped with a camera through one of these ports—a device known as a laparoscope—to visualize the internal organs and pelvic region. Through another port, they utilized laparoscopic scissors for excising endometriosis.
Then problems began.
Dr. Mwangi and Dr. Muteshi report that “the minimally invasive surgical incisions stayed as superficial injuries over an 11-month period even with comprehensive therapy involving a plastic surgeon.” Both specialists are OB-GYNs; additionally, Dr. Muteshi specializes in reproductive medicine.
It took a fourth hospitalization before the truth started to come to light.
The girl
was q
uiet
,
withdrawn,
and
displayed minimal emotions when visiting hospitals.
The
The doctors observed her lack of emotional response and recommended therapy. Initially, she refused. However, one day, she agreed to give it a try.
During that session, the girl disclosed
the truth.
“
She disclosed that she had practiced self-harm using a sharp blade to manage her stomach discomfort.
The doctors mention in their report, entitled “Chronic self-induced laparoscopic injuries due to endometriosis—revealing major depressive disorder: a case study.”
She
explained that she
She felt isolated from her classmates, overwhelmed by frequent hospital stays, and detached from her parents. She was afraid this isolation would continue.
o
To help her pass her final exams.
Despite this, she refused to admit scratching the surgical incisions. However, her medical team became progressively more certain that the recurring harm was self-administered.
–
a quiet plea for assistance.
Yet, why would she resort to self-harm?
They referred her to
a psychiatrist
who made
a determination of major depressive disorder
.
Major Depressive Disorder (MDD) is a severe mental health disorder characterized by
s
Driven by unrelenting sadness, losing enthusiasm for everyday activities, along with various emotional and physical issues that hinder a person’s capacity to perform their duties effectively at work, school, or within personal relationships.
Research indicates that individuals suffering from endometriosis have a higher risk of encountering depression and anxiety compared to those who do not have the disorder.
“
Various research papers have repeatedly demonstrated that
more than half
Of those suffering from endometriosis, many experience moderate to severe emotional disorders.
,” Dr Mwangi says.
“
A limited number of prior investigations have examined how endometriosis impacts the mental well-being of teenagers.
”
Still, the medics say
self-directed violence remains uncommon.
The student was instantly placed
on antidepressants
These medications help address depression and various mental health issues by regulating the brain chemicals that influence your mood and feelings.
What happened next stunned
the
care team.
Surprisingly, her depression symptoms showed improvement,” the report notes. “Additionally, the laparoscopic wounds that had been present for 11 months fully healed.
S
He finished her last exams and proceeded to enroll in college. Her endometriosis is currently controlled through hormone therapy, and she still receives psychiatric assistance.
As far as we know, there have been no documented instances of teenagers suffering from endometriosis presenting with long-lasting abdominal injuries resulting from self-inflicted harm.
,
” stated Dr. Mwangi, who was the principal author of the case study
.
Dr. Mwangi and Dr. Muteshi clarified that the persistent pain resulting from endometriosis was the issue.
can trigger inflammation
within the brain or spinal cord
and heighten pain sensitivity
–
All of these contribute to feelings of depression.
For this young patient, the combination of persistent pain, multiple surgeries, and the psychological impact of a belated diagnosis culminated in a challenging situation.
The
two specialists
encourage physicians to consider more than just physical signs when
surgical
wounds do n
o
t heal.
“Persistent laparoscopic wounds caused by continuous scratching were a warning sign,” they said. “Notably, the wounds healed only after psychiatric intervention.”
T
hey said
t
This instance serves as a valuable lesson.
S
Occasionally, the process of healing begins not within the body.
,
but in the mind.
“
Self-inflicted harm, manifesting in various ways, serves as an alarm bell indicating the requirement for referral to mental health services and potentially psychiatric intervention.
,” they said
.
“
In this case, persistent laparoscopic wounds caused by continuous scratching were a warning sign, however, the patient denied scratching them. Notably, the wounds healed only after psychiatric intervention and initiation of antidepressant therapy
.”
Provided by Syndigate Media Inc. (
Syndigate.info
).
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