Bilious vomiting in two neonates due to an urinoma secondary to posterior urethral valves

•Two neonates presenting acutely with bilious vomiting and abdominal mass.•Both patients underwent series of radiological investigations including abdominal CT scans.•Signs and symptoms due to a large urinoma secondary to post-natally diagnosed posterior urethral valves.•Though uncommon, extrinsic compression of bowel should be considered in neonates with bilious vomiting.

Bilious vomiting is a common presenting sign of intestinal obstruction in the neonate. Here we report two neonates who presented with bilious vomiting due to compression of the proximal small bowel by an urinoma secondary to posterior urethral valves. Awareness of this differential diagnosis may prevent acute exploratory surgery.