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Published in: Journal of Medical Case Reports 1/2009

Open Access 01-12-2009 | Case report

Vernix caseosa peritonitis – no longer rare or innocent: a case series

Authors: Olivia A Stuart, Alastair R Morris, Rodney J Baber

Published in: Journal of Medical Case Reports | Issue 1/2009

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Abstract

Introduction

Vernix Caseosa peritonitis is a rare post caesarean section complication with only 19 case reports in the literature to date. Vernix caseosa spilt at the time of caesarean section is thought to incite an inflammatory reaction, causing symptoms resembling an acute abdomen.

Case Presentation

We discuss three Caucasian patients (aged 32 to 43 years) who presented in our health sector in Sydney with vernix caseosa peritonitis. Each had a protracted course with significant comorbidities requiring surgical and medical intervention. This contrasts with other reports suggesting that a rapid resolution can be expected.
This cluster may be a consequence of the rising caesarean section rate, a heightened local awareness of the condition and possibly a result of leaving material in the paracolic gutters intraoperatively.

Conclusion

Our aim is to increase awareness among our obstetric and surgical colleagues of the characteristic clinical presentation and intra-operative findings of vernix caseosa peritonitis. We also point out that, in contrast to those presented here, not all patients require laparotomy.
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Literature
1.
go back to reference Krumerman MS, Pouliot GJ: Maternal vernix caseosa peritonitis: Rare complication of cesarean section. N Y State J Med. 1976, 11: 1879-1880. Krumerman MS, Pouliot GJ: Maternal vernix caseosa peritonitis: Rare complication of cesarean section. N Y State J Med. 1976, 11: 1879-1880.
2.
go back to reference Hertz MG, Stanley WD, Toot PJ, Freedman SI, Ang EP: Symptomatic material intraperitoneal meconium granulomata. Report of two cases. Diagn Gynecol Obstet. 1982, 4 (2): 147-149. Hertz MG, Stanley WD, Toot PJ, Freedman SI, Ang EP: Symptomatic material intraperitoneal meconium granulomata. Report of two cases. Diagn Gynecol Obstet. 1982, 4 (2): 147-149.
3.
go back to reference Schwartz IS, Bello GV, Feigin G, Sherman DH: Maternal vernix caseosa peritonitis following premature rupture of membranes. JAMA. 1985, 254 (7): 948-950. 10.1001/jama.254.7.948.CrossRefPubMed Schwartz IS, Bello GV, Feigin G, Sherman DH: Maternal vernix caseosa peritonitis following premature rupture of membranes. JAMA. 1985, 254 (7): 948-950. 10.1001/jama.254.7.948.CrossRefPubMed
4.
go back to reference Boothby R, Lammert N, Benrubi GI, Weiss B: Vernix caseosa granuloma: A rare complication of cesarean section. South Med J. 1985, 78 (11): 1395-1396.CrossRefPubMed Boothby R, Lammert N, Benrubi GI, Weiss B: Vernix caseosa granuloma: A rare complication of cesarean section. South Med J. 1985, 78 (11): 1395-1396.CrossRefPubMed
5.
go back to reference Freedman SI, Ang EP, Herz MG, Stanley WD, Toot PJ: Meconium granulomas in post-cesarean section patients. Obstet Gynecol. 1982, 59: 383-385.PubMed Freedman SI, Ang EP, Herz MG, Stanley WD, Toot PJ: Meconium granulomas in post-cesarean section patients. Obstet Gynecol. 1982, 59: 383-385.PubMed
6.
go back to reference George E, Leyser S, Zimmer HL, Simonowitz DA, Agress RL, Nordin DD: Vernix caseosa peritonitis. An infrequent complication of cesarean section with distinctive histopathologic features. Am J Clin Pathol. 1995, 103 (6): 681-684.CrossRefPubMed George E, Leyser S, Zimmer HL, Simonowitz DA, Agress RL, Nordin DD: Vernix caseosa peritonitis. An infrequent complication of cesarean section with distinctive histopathologic features. Am J Clin Pathol. 1995, 103 (6): 681-684.CrossRefPubMed
7.
9.
go back to reference Mahmoud A, Silapaswan S, Lin K, Penney D: Vernix caseosa: An unusual cause of post-caesarean section peritonitis. Am Surg. 1997, 63 (5): 382-385.PubMed Mahmoud A, Silapaswan S, Lin K, Penney D: Vernix caseosa: An unusual cause of post-caesarean section peritonitis. Am Surg. 1997, 63 (5): 382-385.PubMed
10.
go back to reference Tawfik O, Prather J, Bhatia P, Woodroof J, Gunter J, Webb P: Caseosa peritonitis as a rare complication of cesarean section. A case report. J Reprod Med. 1998, 43 (6): 547-550.PubMed Tawfik O, Prather J, Bhatia P, Woodroof J, Gunter J, Webb P: Caseosa peritonitis as a rare complication of cesarean section. A case report. J Reprod Med. 1998, 43 (6): 547-550.PubMed
11.
go back to reference Cummings B, Scarth HM, Tran HT, Walley VM: Caseosa peritonitis presenting post partum as acute cholecystitis. Can J Surg. 2001, 44 (4): 298-300.PubMedPubMedCentral Cummings B, Scarth HM, Tran HT, Walley VM: Caseosa peritonitis presenting post partum as acute cholecystitis. Can J Surg. 2001, 44 (4): 298-300.PubMedPubMedCentral
12.
go back to reference Selo-Ojeme , Donkor P, Francis D: Vernix caseosa peritonitis: An unusual and rare complication of caesarean section. J Obstet Gynaecol. 2007, 27 (2): 190-191. 10.1080/01443610601137721.CrossRefPubMed Selo-Ojeme , Donkor P, Francis D: Vernix caseosa peritonitis: An unusual and rare complication of caesarean section. J Obstet Gynaecol. 2007, 27 (2): 190-191. 10.1080/01443610601137721.CrossRefPubMed
13.
go back to reference Davis JR, Miller HS, Feng JD: Caseosa peritonitis: Report of two cases with antenatal onset. Am J Clin Pathol. 1998, 109 (3): 320-323.CrossRefPubMed Davis JR, Miller HS, Feng JD: Caseosa peritonitis: Report of two cases with antenatal onset. Am J Clin Pathol. 1998, 109 (3): 320-323.CrossRefPubMed
14.
go back to reference Selo-Ojeme D: Vernix caseosa peritonitis. J Obstet Gynaecol. 2007, 27 (7): 660-663. 10.1080/01443610701582792.CrossRefPubMed Selo-Ojeme D: Vernix caseosa peritonitis. J Obstet Gynaecol. 2007, 27 (7): 660-663. 10.1080/01443610701582792.CrossRefPubMed
Metadata
Title
Vernix caseosa peritonitis – no longer rare or innocent: a case series
Authors
Olivia A Stuart
Alastair R Morris
Rodney J Baber
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2009
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-3-60

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