Description

A 24 hour old male child weighing 2.8 Kg exhibiting extrophy of bladder and malformed small penis with epispadias was delivered by lower uterine caesarian section at term due to suspected obstructed labor in a 28 year old female. Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score was 8 at one minute and 9 at five minutes [1,2]. Deficient umbilical wall below level of umbilicus and small penis with epispadias was present. Bladder was covered with plastic wrap to prevent infection. Within 72 hours, first procedure of modern staged surgical repair of bladder extrophy was performed. It included repair and reconstruction of bladder and anterior abdominal wall. At six weeks follow-up the incision was healed and his weight gain was adequate.

Teaching point: This uncommon congenital disorder can only be diagnosed clinically. Thus, prompt identification and management is critical, as the first surgical procedure should be performed within 72 hours of delivery [3,4].

Figure 1: Clinical image.