The urinary bladder of a neonate, infant or small child may rupture, resulting in accumulation of the urine within the peritoneal cavity. Diagnosis may be delayed if the condition is not considered or if findings are ascribed to other conditions such as cirrhosis or renal failure.


Risk factors for rupture of the urinary bladder:

(1) prune belly syndrome

(2) catheterization of the umbilical artery

(3) obstruction of the urinary tract (posterior urethral valve, etc)

(4) penetrating trauma to the abdomen or pelvis

(5) blunt trauma to the abdomen or pelvis with a full bladder

(6) abdominal or pelvic surgery (iatrogenic)

(7) urinary catheterization

(8) acute urinary retention following surgery

(9) neurogenic dysfunction of the bladder

(10) bladder tumor

(11) bladder diverticulum


The rupture may occur in utero or at any time following delivery.


Clinical features of urinary ascites

(1) sudden appearance of ascites

(2) sudden onset of oliguria or anuria

(3) increase in serum creatinine and BUN

(4) high creatinine in the peritoneal fluid


Differential diagnosis:

(1) rupture of the renal pelvis (uretopelvic junction obstruction, etc)

(2) damage to a ureter (this probably would not result in oliguria if unilateral)


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