Systemic air embolism (air in the systemic arterial circulation) is considered a rare complication of CT-guided percutaneous lung biopsy. Though often self-limiting, it can lead to disastrous, even fatal complications when the air embolus reaches the brain or coronary arteries.

Different methods have been advocated to reduce the risk of this complication, one of which is placing the patient so that the lesion to be biopsied lies below the left atrium ³.

If an air embolus is identified, treatment should included 100% oxygen and close monitoring. Depending on the symptoms, hyperbaric oxygen chamber therapy might be indicated. Some have advocated placing the patient in a right decubitus Trendelenburg position in the hopes of keeping the air in the apex of the left ventricle so it does not embolize further in the arterial circulation.

In this specific case, the air was only noted the next morning upon reviewing the images to finalize the report. The referring physician was contacted, who confirmed that the patient was completely asymptomatic neurologically and from a respiratory perspective. Prudently, a follow-up scan was ordered which showed complete resolution of the air embolus.