Volume 28, Issue 153, November 2024

Vernix Caseosa Peritonitis: A case report

Alghamdi Mona Mesfer^1,2, Alshalfan Raed Ibrahim^1,2, Albedah Khalid Fahad^1,2, Almohanna Rema Saad^1,2♦

¹Department of Surgery, King Abdulaziz Medical City, National Guards Health Affairs, Riyadh, KSA
²King Abdullah International Medical Research Center, Riyadh, KSA

^♦Corresponding Author
Department of Surgery, King Abdulaziz Medical City, National Guards Health Affairs, King Abdullah International Medical Research Center, Riyadh, KSA

ABSTRACT

Vernix caseosa peritonitis (VCP) is a rare yet severe complication of cesarean section (C-section), typically resulting from the leakage of meconium or amniotic fluid into the maternal peritoneal cavity during surgery. VCP presents as an acute abdomen days to weeks after an uncomplicated C-section. This report highlights a rare cause of acute abdomen that poses serious diagnostic and therapeutic challenges, with around 34 cases reported in the literature. In this case, a 32-year-old woman arrived at the emergency department ten days after a C-section, experiencing lower abdominal pain, palpitation during exertion, and dysuria. A computed tomography (CT) scan of the abdomen showed a multiloculated fluid collection at the bladder flap, along with moderate ascites and extensive surrounding fat stranding. Peritoneal fluid aspiration yielded 500 mL of pus, which was sent for cultures. The results indicated scanty growth of Prevotella bivia. The patient's condition was complicated by sepsis, Candidemia, and bilateral pleural effusion, necessitating admission to the intensive care unit. Management involved the placement of pelvic draining tubes and the administration of multiple broad-spectrum antibiotics. Given the high prevalence of C-sections nowadays, it is essential to maintain a high level of suspicion and understanding of VCP as a differential diagnosis for postpartum acute abdomen to minimize unnecessary interventions.

Keywords: Peritonitis, Postpartum, Vernix caseosa

Medical Science, 2024, 28, e134ms3453

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DOI: https://doi.org/10.54905/disssi.v28i153.e134ms3453

Published: 09 November 2024