Ozone therapy-associated pneumoperitoneum in a patient with low back pain: A case report
Shamohammadi M, Mazraeh M, Tayebi A, Olamaeian F, et al. International Journal of Surgery Case Reports, 2025.
- Study type
- Case report
- People studied
- 1 person
- Population
- 57-year-old woman with type 2 diabetes, hypertension, and ischemic heart disease, treated with ozone therapy for L4-L5 lumbar disc herniation
- Published
- 2025, International Journal of Surgery Case Reports
- Identifiers
- PMID 40233642, DOI 10.1016/j.ijscr.2025.111289
What the authors reported
Ten minutes after her second ozone therapy session for lumbar disc herniation the patient developed abdominal pain and distension. X-rays and CT showed free air in the peritoneum and retroperitoneum without free fluid, and blood tests showed no notable abnormalities. She was treated without surgery in intensive care, discharged after five days, and was asymptomatic at one month.
What limits this result
Single case report. The authors state that the mechanism is undefined and suggest high-pressure ozone administration or improper instrument insertion. The route, site, ozone concentration, and volume of the session are not reported, and follow-up was one month.
Harms reported after ozone therapy, and studies of how ozone exposure affects health. One study rarely settles a medical question; our guides weigh each paper against the rest of the evidence.
How the study was done
- Design
- Case report
Ozone therapy-associated pneumoperitoneum in a patient with low back pain: A case report
- Setting
- Firoozabadi Clinical Research Development Unit (FACRDU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran (author affiliation)
- Read from
- Read from the full text of the paper. Read on September 29, 2026.
Source: Abstract on PubMed
Study arms
| Group | Participants | What they received |
|---|---|---|
| Single patient | Not reported | Ozone therapy for lumbar disc herniation: a second session at another center, a month after the first |
Source: Full text on PubMed Central
Procedure as reported
- Sessions
- Two sessions, a month apart; the second at another center
A month after her first ozone therapy session, the patient underwent a second session at another center.
In the paper's own units, not converted.
Source: Full text on PubMed Central
What it measured
- Symptom onset
- Abdominal pain and distension ten minutes after the second session
Ten minutes following this procedure, she developed abdominal pain and distension.
- Symptoms on admission
- Nausea, abdominal distension, abdominal pain, and chest pain
- Chest and abdominal X-rays
- Subdiaphragmatic, perirenal, and psoas free air
- CT scan with IV contrast
- Intra-abdominal and retro-abdominal scattered free air; no free fluid
- Laboratory results
- No clinically significant CBC abnormalities indicating infection or inflammation; no pancreatic or liver abnormalities
The Laboratory results did not demonstrate any clinically significant abnormalities in the CBC that would indicate an infectious or inflammatory condition, nor were there any pancreatic or liver abnormalities.
- Management
- Admitted to the intensive care unit for conservative treatment
Instantly, the patient was admitted to the intensive care unit (ICU) and was approved for conservative treatment.
- CT scan without contrast before discharge
- Amount of free air in the abdomen considerably decreased
- Discharge
- Discharged in stable condition after five days of non-surgical and symptomatic treatment
Safety as reported
Pneumoretroperitoneum and pneumoperitoneum, diagnosed as secondary to ozone therapy
Source: Full text on PubMed Central
Follow-up
One month; asymptomatic, with no recurrence of previous symptoms
Source: Full text on PubMed Central
Funding and conflicts
Did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors
Source: Full text on PubMed Central
Where we cite this study
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