Spontaneous intraperitoneal bladder rupture in a pediatric patient due to pan-urethral stricture

Spontaneous bladder rupture (SBR) in children is rare and typically linked to posterior urethral valves in neonates. We report the first known case of intraperitoneal bladder rupture secondary to urethral stricture in a 9-year-old male with Balanitis Xerotica Obliterans and prior genitourinary surgeries. He presented with abdominal pain, nausea, and urinary retention. Despite partial urine output, he was found to have bladder perforation managed with laparotomy and suprapubic diversion. This case emphasizes the need for high clinical suspicion, highlights limitations of standard CT, and supports dedicated cystography and early surgical intervention in children with obstructive uropathy.