Vernix caseosa peritonitis - no longer rare or innocent: a case series.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
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.
Stuart
Olivia A
OA
Department of Women's & Children's Health, Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia. oliviastuart@yahoo.com.
Morris
Alastair R
AR
Baber
Rodney J
RJ