Urinary ascites from spontaneous bladder perforation in female neonate

Ankur Arya,Vikash Kumar,Prakash Pawar,Ashwin Sunil Tamhankar

doi:10.14534/pucr.2015614087

Abstract

Urinary ascites from bladder perforation in neonate is a rare event reported to occur more commonly following umbilical artery catheterization. Other causes include bladder perforations in neonates with bladder abnormalities, following bladder instrumentation or idiopathic bladder perforations. The present manuscript describes a full-term female neonate with spontaneous bladder perforation who was successfully managed with early operative intervention. We also present a review of the current literature and also discuss the pathogenesis, diagnosis and management of this rare entity.

Highlights

Ascites in neonatal period is a rare event and in about one fourth of cases urinary system is implicated as a cause [1]
We describe a full-term female neonate with urinary ascites secondary to spontaneous bladder perforation who was successfully managed with early operative intervention
The most accepted explanation for spontaneous bladder rupture is prolonged exposure to hypoxia resulting in ischemic visceral damage to bladder, leading to perforation [9]

Summary

INTRODUCTION

Ascites in neonatal period is a rare event and in about one fourth of cases urinary system is implicated as a cause [1]. One review reported about 75% cases of bladder perforations was secondary to umbilical artery catheterization [2]. Idiopathic bladder perforation is relatively uncommon cause of neonatal urinary ascites with only isolated case reports [5,6,7,8,9,10]. We describe a full-term female neonate with urinary ascites secondary to spontaneous bladder perforation who was successfully managed with early operative intervention. CASE REPORT A full term, 2.7 kilograms female neonate presented on fifth day of life with progressive abdominal distension and failure to pass urine since birth. There were two side-by-side perforations on posterior aspect of bladder dome with thinned out surrounding bladder wall (Fig.2)

DISCUSSION

Upadhyaya