Vernix caseosa peritonitis: a mimic for post-partum appendicitis


  • James N. Sellars Department of General Surgery, Cairns Hospital, Cairns, Queensland, Australia
  • Ryan Green Department of General Surgery, Cairns Hospital, Cairns, Queensland, Australia
  • Eshwarshanker Jeyarajan Department of General Surgery, Cairns Hospital, Cairns, Queensland, Australia



Vernix caseosa peritonitis, Acute appendicitis, Post-partum, Acute abdomen, Acute abdominal pain


Vernix caseosa peritonitis is an uncommon pathology predominantly affecting post-partum women who have undergone caesarean section and has symptomatology identical to common intra-abdominal surgical pathology. Cross-sectional imaging may not differentiate this from an alternative aetiology, thus a broad range of differentials must be considered in the early post-partum patient. This case of a 26 year-old post-partum patient who underwent an appendicectomy for CT-confirmed appendicitis had a histological diagnosis of vernix caseosa peritonitis. This case demonstrates the diagnostic challenge of acute abdominal pain in the early post-partum period and the high index of suspicion that clinicians must have to reach these uncommon diagnoses.


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