Vernix caseosa peritonitis as a rare complication of cesarean section. A case report
Tawfik, O.; Prather, J.; Bhatia, P.; Woodroof, J.; Gunter, J.; Webb, P.
Journal of Reproductive Medicine 43(6): 547-550
1998
ISSN/ISBN: 0024-7758 PMID: 9653703 Document Number: 490119
Background: Vernix caseosa peritonitis is a rare complication of cesarean section with distinctive histopathologic findings. Case: Vernix caseosa peritonitis occurred in a 28-year-old, pregnant woman following emergency cesarean section. Exploratory laparotomy revealed right subphrenic and perihepatic fluid collections with multiple small abdominal abscesses. Cytopathologic examination of the peritoneal lavage specimen showed a purulent inflammatory exudate admixed with occasional squamous debris, portions of hair shafts, meconium pigment, and foamy and multinucleated giant cells. During hospitalization the patient had developed Clostridium perfringens acute endometritis, presumably due to aggressive treatment with broad-spectrum antibiotics. Conclusion: Pathologists are in a unique position to make the correct diagnosis in an otherwise-ambiguous clinical presentation because of the distinctive histopathologic and cytopathologic findings of this entity. Computed tomography-guided fine needle aspiration cytologic evaluation can be diagnostic in such cases.