CTICasesDouble Wall Sign of Pneumothorax in Bullous Emphysema
Imaging findings
Chest radiograph and CT in a patient with severe bullous emphysema show a large left-sided pneumothorax. The 'double wall sign' is present, where the thin wall of a large bulla is seen running parallel to but separate from the parietal pleural surface.
Key takeaways
In patients with severe bullous emphysema, distinguishing a pneumothorax from a large bulla on chest radiograph can be difficult. The 'double wall sign' (seeing both sides of the bulla wall because air is present in both the bulla and the pleural space) confirms the presence of a pneumothorax.
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