August, 2017 2017; Vol1; Issue7 http://iamresearcher.online To Cite This Article: Theophile Njamen Nana,Paul N. Tolefac, Charlotte Nguefack Tchente, Calypse Ngwasiri, Rita Frinue Tamambang, Kouam Siegning, Alain Mefire Chichom. The Pitfalls of Imaging in the Antenatal Diagnosis of Bladder Extrophy-Epispadias Complex in a Resource-low Setting. International Annals of Medicine. 2017;1(5). https://doi.org/10.24087/IAM.2017.1.7.195 The Pitfalls of Imaging in the Antenatal Diagnosis of Bladder Exstrophy-Epispadias Complex in a Resource-low Setting Theophile Njamen Nana 1,2 , Paul N. Tolefac 2,3,4 , Charlotte Nguefack Tchente 1,5 , Calypse Ngwasiri 4 , Rita Frinue Tamambang 3 , Kouam Siegning 6 , Alain Mefire Chichom 1,7 1 Service of Obstetrics and Gynaecology, Douala general hospital, Douala, Cameroon 2 Faculty of Health Sciences, University of Buea, Cameroon 3 Faculty of Medicine and Biomedical Sciences, University of Buea, Cameroon 4 Clinical Research Education Networking and Consultancy 5 Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon 6 Faculty of Medicine University of Heidelberg Germany 7 Service of Paediatric surgery, Douala Gynaeco-Obstetric and Paediatric Hospital, Douala, Cameroon Corresponding Author: Dr. Theophile Nana Njamen njanatheo@yahoo.fr ABSTRACT Background: Bladder exstrophy is a rare congenital malformation of the genitourinary system usually associated with other malformations. Case summary: We report the case of a new born delivered vaginally at term with bladder exstrophy-epispadias complex. Three antenatal ultrasounds scan done all missed the diagnosis. Medical management was done, and the patient was discharged against medical advice 48 hours later with surgical intervention deferred due to lack of consent. Conclusion: The diagnosis and management of bladder exstrophy – epispadias complex remains a challenge in our surroundings. Radiologists should maintain a high index of suspicion during antenatal ultrasounds. Reporting: Care 2016 guideline. Keywords: Bladder exstrophy, epispadias, antenatal ultrasound, case report 1. INTRODUCTION Bladder exstrophy-epispadias complex (BEEC) is a complex congenital anomaly of the genitourinary system with a spectrum of congenital malformations ranging from isolated epispadias, to classical bladder exstrophy, to cloacal exstrophy as the most severe—and rarest–presentation. The malformation may extend to involve the genitalia, the abdominal wall muscles, the pelvic floor musculature, and the bony pelvis (1,2) . It is an extremely rare congenital malformation with an overall incidence estimated by Nelson et al. (3) at 2.15 per 100,000 live births with classical bladder exstrophy estimated at 1:10,000 to 1:50,000 live births and epispadias estimated at 1:117,000 live births (4) . BEEC results from an insult during the development of the urogenital system during which there is a disorder leading to cloacal membrane overgrowth preventing medial migration of mesenchymal tissue (1) . Surgery remains the main stay of management with adequate abdominal wall closure, achieving urinary continence with renal function preservation and adequate cosmetic/functional genital reconstruction being the approach considerations. The currently