Shamohammadi Mohammadsadra, Mazraeh Maryam, Tayebi Ali, Olamaeian Faranak, Moallem Hirbod Hadizadeh
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
Firoozabadi Clinical Research Development Unit (FACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Int J Surg Case Rep. 2025 May;130:111289. doi: 10.1016/j.ijscr.2025.111289. Epub 2025 Apr 13.
Ozone therapy has been used for patients with low back pain due to disc herniation. Owing to its analgesic and anti-inflammatory properties, this method alleviates low back pain and often improves physical function through lumbar injection. Despite its therapeutic potential, the complications associated with ozone therapy are not yet fully understood.
A 57-year-old woman with a history of diabetes mellitus was admitted to the emergency department with acute abdominal pain and distension and chest pain, which occurred following her last session of ozone therapy. At first, the patient had been diagnosed with peritonitis based on initial symptoms. However, blood tests did not reveal any notable abnormalities. After identifying the presence of free air on the abdominal X-ray and the IV contrast-enhanced computed tomography scan of the abdomen revealed retroperitoneal and intraperitoneal air indicative of pneumoperitoneum and pneumoretroperitoneum. The patient was discharged in stable condition after five days of non-surgical and symptomatic treatment.
This is a rare case of pneumoperitoneum and pneumoretroperitoneum, which also highlights a new complication of ozone therapy. Despite the exact pathophysiological mechanisms being unclear, the high pressure of ozone administration or technique may be the causative factors. Conservative management demonstrated favorable prognostic outcomes and an effective treatment response.
Spontaneous pneumoperitoneum presents with severe abdominal pain and the presence of free air in the abdominal cavity. Typically, it does not require surgical intervention. However, Conservative treatment resulted in a dramatic improvement in the initial clinical condition and decreased the amount of free air within the abdominal cavity.
臭氧疗法已用于因椎间盘突出症导致腰痛的患者。由于其镇痛和抗炎特性，这种方法可缓解腰痛，并常常通过腰椎注射改善身体功能。尽管具有治疗潜力，但与臭氧疗法相关的并发症尚未完全明确。
一名有糖尿病病史的57岁女性因在最后一次臭氧治疗后出现急性腹痛、腹胀和胸痛而被收入急诊科。起初，根据初始症状该患者被诊断为腹膜炎。然而，血液检查未发现任何明显异常。在腹部X线检查发现存在游离气体，且腹部静脉注射造影剂增强计算机断层扫描显示腹膜后和腹腔内有气体，提示存在气腹和腹膜后积气。经过五天的非手术对症治疗后，患者病情稳定出院。
这是一例罕见的气腹和腹膜后积气病例，也凸显了臭氧疗法的一种新并发症。尽管确切的病理生理机制尚不清楚，但臭氧注射的高压或技术可能是致病因素。保守治疗显示出良好的预后结果和有效的治疗反应。
自发性气腹表现为严重腹痛和腹腔内存在游离气体。通常，它不需要手术干预。然而，保守治疗使初始临床状况有显著改善，并减少了腹腔内游离气体的量。
