Endoscopic sealing of a chronic bronchopleural fistula using acrylate co-monomer glue

A bronchopleural fistula (BPF) consists of a direct communication between the bronchial tree and the pleural space, which can develop secondary to (pleuro) pneumonia. Thoracotomy has been reported as a viable treatment option in cases of nonresponsive pleuropneumonia, pleural abscess formation and necrotising pneumonia. The presence of a BPF can delay and even prevent healing of the thoracotomy site, with clinical signs of coughing and putrid purulent nasal discharge often seen. In this case report, we describe the diagnosis and localisation of a bronchopleural fistula using retrograde instillation of methylene blue through the thoracotomy site, followed by the successful closure of the BPF using endoscopic application of acrylate co-monomer glue (Glubran 2^®).