George E, Leyser S, Zimmer H L, Simonowitz D A, Agress R L, Nordin D D
Department of Pathology, Overlake Hospital Medical Center, Bellevue, Washington 98004, USA.
Am J Clin Pathol. 1995 Jun;103(6):681-4. doi: 10.1093/ajcp/103.6.681.
The authors report two cases of vernix caseosa peritonitis, an infrequent complication of cesarean section with distinctive histopathologic findings. Both patients underwent exploratory laparotomy for unexplained abdominal pain after cesarean section. Histopathologic evaluation of surgically removed tissue revealed an organizing peritonitis, which included prominent collections of anucleate squamous cells in association with a foreign body-type granulomatous response. In both cases, the surgical pathologist suggested that the abdominal pain was likely a result of peritoneal reaction to spillage of keratinous material (vernix caseosa) derived from amniotic fluid contents during cesarean section. Surgical pathologists should be aware of this entity and include it in the differential diagnosis of acute abdominal pain.
作者报告了两例羊水胎脂性腹膜炎病例，这是剖宫产术后一种罕见的并发症，具有独特的组织病理学表现。两名患者均因剖宫产术后不明原因的腹痛接受了剖腹探查术。对手术切除组织的组织病理学评估显示为组织化腹膜炎，其中包括大量无核鳞状细胞聚集，并伴有异物型肉芽肿反应。在这两个病例中，手术病理学家认为腹痛可能是由于剖宫产术中羊水内容物中的角质物质（羊水胎脂）溢出引起的腹膜反应所致。手术病理学家应了解这一病症，并将其纳入急性腹痛的鉴别诊断中。
