title: Vernix caseosa peritonitis. An infrequent complication of cesarean section with distinctive histopathologic features.
abstract: The authors report two cases of vernix caseosa peritonitis, an infrequent complication of cesarean section with distinctive histopathologic findings. Both patients underwent exploratory laparotomy for unexplained abdominal pain after cesarean section. Histopathologic evaluation of surgically removed tissue revealed an organizing peritonitis, which included prominent collections of anucleate squamous cells in association with a foreign body-type granulomatous response. In both cases, the surgical pathologist suggested that the abdominal pain was likely a result of peritoneal reaction to spillage of keratinous material (vernix caseosa) derived from amniotic fluid contents during cesarean section. Surgical pathologists should be aware of this entity and include it in the differential diagnosis of acute abdominal pain.
authors.affiliation: Department of Pathology, Overlake Hospital Medical Center, Bellevue, Washington 98004, USA.
authors.forename: E
authors.initials: E
authors.lastname: George
authors.forename: S
authors.initials: S
authors.lastname: Leyser
authors.forename: H L
authors.initials: HL
authors.lastname: Zimmer
authors.forename: D A
authors.initials: DA
authors.lastname: Simonowitz
authors.forename: R L
authors.initials: RL
authors.lastname: Agress
authors.forename: D D
authors.initials: DD
authors.lastname: Nordin
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010149:Postoperative Pain / Q000175:diagnosis; D010538:Peritonitis / Q000209:etiology* / Q000473:pathology*; D011247:Pregnancy; D014708:Vernix Caseosa