CTICasesVenous air embolism
Imaging findings
Contrast-enhanced chest CT in a trauma patient shows pockets of air within the anterior pulmonary artery branches in the upper and lower lobes, producing a double barrel appearance (air and contrast outlining the vessel next to the bronchus), representing inadvertent venous air injection during contrast administration.
Key takeaways
Inadvertent injection of air during intravenous contrast administration can lead to venous air embolism, where the embolized air selectively localizes in the anterior, non-dependent branches of the pulmonary arteries. On CT, this presents as the 'double barrel sign' and an air-contrast level.
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