Abstract
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.