Vernix caseosa: an unusual cause of post-cesarean section peritonitis

Surgeons should be aware of a very unusual cause of post-cesarean section peritonitis. This rare form of peritonitis is caused by the spillage of vernix caseosa material into the peritoneal cavity. The exact mechanism of the development of peritonitis in these few cases is unknown. Clinically, vernix caseosa peritonitis should be considered in the post-cesarean section acute abdomen after excluding the more common causes of peritonitis such as appendicitis and perforated viscus. Intraoperatively, the presence of cheese-like yellow patches limited to the serosal layer of visceral organs is the most characteristic feature. Histopathological examination of these serosal patches reveal the desquamated anuclear squamous cells confirming the diagnosis. Postoperative treatment with antibiotics should be continued. The addition of steroids (only after confirming the diagnosis pathologically) has a significant effect on improving the clinical outcome.