Abstract
Background: The incidence of birth injury has decreased due to improved perinatal care. Although intra-abdominal solid visceral birth injury resulting in hemoperitoneum in a newborn is uncommon, it must be considered in the first 48 hours of life in a baby with pallor, anemia, abdominal distension, and shock.
Case Reports: Two neonates managed in this center within a month following intrapartum splenic and hepatic injury, respectively, presented diagnostic and management challenges, with one mortality recorded. The challenges and outcome of management are highlighted to heighten the clinician’s suspicion of this condition in a newborn with unexplained pallor and progressive abdominal distension.
Conclusions: Early referral of a newborn with unexplained cause of progressive abdominal distension, pallor, and anemia for surgical consultation should be encouraged.

Keywords: olid visceral, intra-abdominal, neonates, Birth Injuries