Retrograde instillation of methylene blue for the localization of bronchopleural fistula

Bronchopleural fistulas (BPF) resulting from pulmonary resection, radiation, or a direct tumor mass effect are associated with significant morbidity, reduced quality of life, and increased risk of mortality. Diagnosing BPF can be challenging, even with computed tomography, magnetic resonance imaging, and bronchoscopy. We report a case in which retrograde methylene blue instillation during bronchoscopy successfully confirmed the diagnosis of BPF.