A 46 year-old man with esophageal carcinoma complicated by a bronchoesophageal fistula presented with recurrent pneumonia in the same lung field. Bronchoscopic examination ruled out an endobronchial lesion. The first bronchoscopy only showed purulent secretions in the lumen of the right B6. A second bronchoscopy using methylene blue ingestion showed the blue dye gushing from the lumen of the right B6, and a bronchoesophageal fistula involving the superior segment of right lower lobe and esophagus was diagnosed. This report shows the limitation of routine bronchoscopy and underscores the value of using methylene blue ingestion during bronchoscopy in patients suspected of having a bronchoesophageal fistula.
Journal of Bronchology7:143-146, 2000.
Address reprint requests to Dr. Shih-Feng Liu. Division of Chest Medicine. Department of Internal Medicine, Chang Gung Memorial Hospital. 123, Ta-Pei Road. Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan, R.O.C.
© 2000 Lippincott Williams & Wilkins, Inc.