Neonatal bladder rupture

Abstract

Neonatal bladder rupture is rare as a complication of bladder obstruction due to abnormal anatomy or iatrogenic cause such as umbilical catheterization. The present study describes the case of a 27-day old infant with ascites due to bladder perforation secondary to bladder wall necrosis as a result of severe urinary tract infection. The baby was treated aggressively with antibiotics and underwent successful surgical repair of the perforation.

Laparoscopic repair of bladder rupture in a neonate

“…Bladder rupture in neonates is a rare entity, with just 26 reported cases, except for iatrogenic injury . Eight of these cases, including the present case, were suspected of having bladder rupture in the prenatal period with evidence of urinary ascites .…”

“…Bladder rupture in neonates is a rare entity, with just 26 reported cases, except for iatrogenic injury. [1][2][3][4][6][7][8] Eight of these cases, including the present case, were suspected of having bladder rupture in the prenatal period with evidence of urinary ascites. 2,6 The cause of neonatal bladder rupture was elevation of intravesical pressure as a result of urethral obstruction in seven of eight reported cases whose cause was described in detail.…”

“…Bladder decompression by urethral catheterization or cystostomy and surgical repair are the choices of treatment for this condition. However, which treatment chosen is still controversial . Although laparoscopic management is the recent preferred option of surgical repair for bladder rupture in adults, no neonatal cases have been reported .…”

“…However, which treatment chosen is still controversial. [2][3][4] Although laparoscopic management is the recent preferred option of surgical repair for bladder rupture in adults, no neonatal cases have been reported. 5 We report the first prenatally diagnosed case of bladder rupture where the patient underwent laparoscopic repair just after birth.…”

Iatrogenic neonatal bladder perforation

“…Once bladder perforation is diagnosed, several authors advocate for aggressive management with an open repair. [8] However, conservative management with catheter drainage and broad-spectrum antibiotics has been proposed by some authors. [47] In our case, since the etiologic cause of the bladder perforation was not possible on radiographic findings, surgical exploration was needed.…”