Ludwig’s Angina in Somalia: Clinical Characteristics, Management, and Outcomes from a Tertiary Emergency Department Retrospective Study. First report of Ludwig’s angina in Somalia

Abstract Background and Objectives Ludwig’s angina is a life-threatening cellulitis of the submandibular space that can rapidly compromise the airway. Despite its clinical importance, data from Somalia are lacking. This study aims to document the demographic distribution of Ludwig’s angina, evaluate patients who presented at Mogadishu Somali Turkey Training and Research Hospital over one year, and analyze the causes, complications, length of hospital stay, treatment, outcomes, and management approaches used. Materials and Methods A retrospective analysis was conducted on 90 patients diagnosed with Ludwig’s angina. Demographic and clinical data, including age, sex, cause, referral source, duration of symptoms, length of hospital stay, clinical presentation, and treatment modality, were recorded and analyzed. Results Ludwig’s angina was more prevalent in males (77.8%), with a mean patient age of 39.1 years. The leading cause was odontogenic infection (65.5%), most commonly periodontal abscesses (34.4%). Surgical decompression was performed in 38.9% of patients, whereas targeted antibiotic therapy was administered in 46.7%. Complications were observed in 48.9% of cases, with septicemia being the most frequent (36.7%). A statistically significant correlation was found between prolonged hospital stays and the severity of clinical manifestations (B = 0.500, p < 0.001). Importantly, no mortality was recorded. Conclusion This study highlights a high complication rate and frequent delayed presentation among Somali patients with Ludwig’s angina, although no deaths were reported. Early recognition, timely airway management, and surgical drainage remain crucial to prevent morbidity. Improved access to dental care and early referral could help reduce the burden of this potentially fatal condition in resource-limited settings.