Massive Hemothorax from Bronchial Artery Bleeding after Endobronchial Ultrasound Transbronchial Needle Aspiration

Endobronchial Ultrasound (EBUS) with Transbronchial Needle Aspiration (TBNA) is performed with a very low complication rate. We present a unique case of massive life-threatening hemothorax from bronchial artery bleeding after EBUS-TBNA, presenting in a delayed fashion and requiring operative intervention. Although exceedingly rare, along with the unusual delayed timing of the presentation, practitioners should be aware of this complication. It may be helpful to perform EBUS with color doppler examination of the subcarinal space to identify and avoid bronchial arteries prior to TBNA of subcarinal lymph nodes.