Spontaneous bladder perforation in a neonate

A Rare Cause of Ascites in Preterm Baby: A Case Report

Bladder rupture leading to urinary ascites in neonates is a very rare occurrence. It can present as a clinical emergency, requiring resuscitation, ventilator support, and acute derangement in renal function. There are only a few reported cases so far in the literature. The commonest etiology is posterior urethral valves which can occasionally lead to urinary ascites even in fetal life. But other proposed etiologies are umbilical arterial catheterization in extreme preterm babies and iatrogenic due to urethral catheterization injuries. Early detection is crucial so that appropriate management, including surgical drainage of the urine if performed early, can lead to the normalization of renal function. Large perforations may need surgical repair after stabilization. These cases can be a challenge for both neonatologists and surgeons. We report a case of bladder perforation in an extreme preterm baby at our hospital.

Intraperitoneal Bladder Perforation and Life-threatening Renal Failure in a Neonate Following Circumcision With the Plastibell Device

We present the case of an infant who suffered intraperitoneal bladder perforation secondary to routine neonatal circumcision with the Plastibell device. On day-of-life 5, the patient presented with abdominal distention, vomiting, diarrhea, and severe acute renal failure. After removal of a distal meatal obstruction caused by the Plastibell device and open repair of the bladder defect, the patient had an uneventful recovery with rapid return of renal function. Despite the relative safety of the Plastibell, this case underscores the importance of careful device placement, parental education, keen clinical judgment, and prompt intervention when indicated.