Pharyngeal or esophageal injuries secondary to endotracheal or nasogastric intubation are not uncommon. Since complication related to injuries of the pharynx and esophagus can be fatal, early diagnosis and adequate treatment are essential. We present a case of hypopharyngeal bleeding following a difficult endotracheal intubation and difficult nasogastric tube placement. Our patient was a 60-year-old man who complained of excessive pharyngeal bleeding. Angiography revealed extraluminal leakage from the left superior thyroid artery. The neck was explored surgically through the left anterior border of the sternocleidomastoid muscle. We ligated the vessel responsible for the bleeding, removed the ulcerated mucosa on the left pyriform sinus, and then closed the defect in the pharyngeal mucosa. The total blood loss was 7000ml from the initial bleeding to the end of the surgical procedure. The patient did not suffer from bleeding, mediastinitis and other complications after the operation. The patient then made an uneventful and prompt recovery.
