Abdominal distension and urinary retention are rare conditions in infants. In the case of female newborns, these two conditions, particularly when concurrent, also include hydrocolpos caused by an imperforate hymen. The prognosis for the latter is generally good, and although severe nephrological, urological and infectious complications can arise they are predictable and can be treated through early diagnosis and drainage of the hydrocolpos.

In limited-resource settings, it is often difficult to make an early diagnosis of an imperforate hymen, thus greater attention and accuracy are called for during the physical examination and perineal inspection of female infants.

The case reported here involved an eight-day-old baby girl with symptoms of abdominal distension and urinary retention. The diagnosis revealed the presence of a large hydrocolpos, complicated by obstructive uropathy, sepsis and bladder perforation. Despite the gravity of the case and the lack of appropriate equipment with which to manage it, the newborn was operated on successfully and discharged in good condition.