Vernix caseosa peritonitis as a rare complication of cesarean section. A case report.
BACKGROUND
Vernix caseosa peritonitis is a rare complication of cesarean section with distinctive histopathologic findings.


METHODS
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.


CONCLUSIONS
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.
Tawfik
O
O
Department of Pathology and Laboratory Medicine, Kansas University Medical Center, Kansas City 66160, USA. otawfik@kumc.edu
Prather
J
J
Bhatia
P
P
Woodroof
J
J
Gunter
J
J
Webb
P
P
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001707:Biopsy, Needle; D002585:Cesarean Section / Q000009:adverse effects*; D003015:Clostridium Infections / Q000209:etiology; D003016:Clostridium perfringens; D004322:Drainage; D004638:Emergency Treatment; D004716:Endometritis / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D011247:Pregnancy; D007507:Therapeutic Irrigation; D014708:Vernix Caseosa
D000900:Anti-Bacterial Agents