Usefulness of the double-wall sign in detecting pneumothorax in patients with giant bullous emphysema

Abstract

Objective: We describe a new sign improving detection of pneumothorax in patients with giant bullous emphysema: air surrounding both sides of the bulla wall (the intrathoracic equivalent of the double-wall sign of pneumoperitoneum). We report the radiographic and CT appearances of the double-wall sign in seven patients with giant bullous emphysema, four of whom had pneumothorax.

Conclusion: Recognizing the double-wall sign of pneumothorax should aid in the triage of patients with giant bullous emphysema.