{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:45Z","timestamp":1756425825710,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,18]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Vernix caseosa peritonitis (VCP) is a rare condition characterised by non-necrotising granulomatous inflammation within the peritoneal cavity following childbirth. Its presentation is typically with acute abdominal pain and fever following caesarean section (CS), and management involves broad-spectrum antibiotics and surgical intervention. Conservative management is rare.<\/jats:p>\n               <jats:p>We report two cases of VCP, which presented with abdominal masses 4\u2009weeks following elective CS. CT scan demonstrated a soft tissue mass with diffuse peritoneal thickening, suspicious for an atypical infection or malignancy. Biopsy revealed non-necrotising granulomatous inflammation consistent with VCP. Both patients were managed conservatively and experienced a full recovery.<\/jats:p>\n               <jats:p>In spite of increasing CS rates, VCP remains a rarely reported complication which may be underdiagnosed. It should be considered in patients presenting with abdominal pain beyond the usual timeframe for infection, with careful examination to detect any soft tissue masses. Conservative management, with biopsy for histological diagnosis, may be a safe option for systemically well women in whom urgent surgical intervention is not indicated.<\/jats:p>","DOI":"10.1136\/bcr-2024-264641","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T04:15:17Z","timestamp":1748924117000},"page":"e264641","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Vernix caseosa peritonitis presenting as a soft tissue mass"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1177-308X","authenticated-orcid":false,"given":"Laura","family":"Wharton","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa","family":"Bonnett","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Ferriman","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeleine","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"2025082802513115000_18.6.e264641.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2011.01309.x"},{"key":"2025082802513115000_18.6.e264641.2","doi-asserted-by":"crossref","first-page":"106","DOI":"10.5937\/afmnai39-31021","article-title":"Preterm prelabour rupture of membranes and Vernix Caseosa Peritonitis: A case report","volume":"39","author":"Mihajlovi\u0107","year":"2022","journal-title":"Acta Fac Medic Naissensis"},{"key":"2025082802513115000_18.6.e264641.3","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/109.3.320"},{"key":"2025082802513115000_18.6.e264641.4","doi-asserted-by":"crossref","unstructured":"Mohd Yusof NN , Mohd Samat N , Mohd Judin A . Post Vaginal Delivery with Impending Silent Abdominal Catastrophe: A Case of Vernix Caseosa Peritonitis. Imjm 2023;22. doi:10.31436\/imjm.v22i4.2092","DOI":"10.31436\/imjm.v22i4.2092"},{"key":"2025082802513115000_18.6.e264641.5","doi-asserted-by":"crossref","first-page":"147","DOI":"10.4137\/CCRep.S12771","article-title":"Vernix caseosa peritonitis after vaginal delivery","volume":"6","author":"Sadath","year":"2013","journal-title":"Clin Med Insights Case Rep"},{"key":"2025082802513115000_18.6.e264641.6","first-page":"819","article-title":"Vernix caseosa peritonitis after vaginal delivery: A rare and unrecognized postpartum complication","volume":"47","author":"Cathelain","year":"2019","journal-title":"Gynecol Obstet Fertil Senol"},{"key":"2025082802513115000_18.6.e264641.7","doi-asserted-by":"crossref","unstructured":"Belak Magdaleni\u0107 U , Koren J , \u0160ramek Zatler S , et al . Difuzni peritonitis, povzro\u010den z verniksom \u2013 prikaz primera in pregled literature. ZdravVestn 2023;1\u20135. doi:10.6016\/ZdravVestn.3397","DOI":"10.6016\/ZdravVestn.3397"},{"key":"2025082802513115000_18.6.e264641.8","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1308\/003588412X13373405385296","article-title":"Delayed presentation of vernix caseosa peritonitis","volume":"94","author":"Chambers","year":"2012","journal-title":"Ann R Coll Surg Engl"},{"key":"2025082802513115000_18.6.e264641.9","doi-asserted-by":"crossref","unstructured":"Yang CHJ , Eykman EN , Smith CJ , et al . Vernix Caseosa Peritonitis Causing Acute Abdomen After Cesarean Section: A Case Series. Am J Case Rep 2022;24. doi:10.12659\/AJCR.938276","DOI":"10.12659\/AJCR.938276"},{"key":"2025082802513115000_18.6.e264641.10","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/S0140-6736(10)60875-6","article-title":"A cheesy diagnosis","volume":"376","author":"Wisanto","year":"2010","journal-title":"Lancet"},{"key":"2025082802513115000_18.6.e264641.11","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.jogoh.2018.08.012","article-title":"A case study of vernix caseosa peritonitis","volume":"47","author":"Vieillefosse","year":"2018","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"2025082802513115000_18.6.e264641.12","doi-asserted-by":"crossref","DOI":"10.1093\/ajcp\/105.2.251","article-title":"Complications from cesarean section","volume":"105","author":"Zellers","year":"1996","journal-title":"Am J Clin Pathol"},{"key":"2025082802513115000_18.6.e264641.13","unstructured":"fernando VJ , Mayorga M , Garc\u00cda-arranz P , et al . 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