A bronchovascular fistula is a bleeding complication after surgery within the thoracic cavity that is the result of improper healing of the lung tissue causing abnormal connections between the bronchi and arteries or veins. Cases have been reported after various thoracic surgeries, although this complication is most common after procedures involving the descending thoracic aorta. Patients may present anywhere from weeks to years after the initial precipitating procedure. Cases of bronchovascular fistula after surgery have been documented in patients of all ages, but this is more common in the adult population.

Intermittent hemoptysis is often the first symptom, followed by an acute-onset massive hemoptysis that can lead to hypovolemia and death.

Dieulafoy disease of the lung, a rare condition associated with vascular irregularities that are more susceptible to bleeding and hemorrhage, may also cause hemoptysis and bronchovascular fistula in patients without a history of lung interventions.

Bleeding bronchovascular fistulae require immediate surgical evaluation.