A patient in her 50s with an unruptured left internal carotid aneurysm was prescribed two anti-platelet agents (aspirin and clopidogrel) before coil embolization. Under general anesthesia, coil embolization of the aneurysm was performed. Following extubation, the patient vomited blood and felt strong pain in her upper abdomen. Based on contrast-enhanced computed tomography and endoscopy, we diagnosed her as having an esophageal submucosal hematoma. Conservative therapy led to good healing as indicated by follow-up endoscopy. Esophageal submucosal hematoma is rare. In the present case, anti-platelet agents appeared to have been the main cause of the esophageal submucosal hematoma. The possibility of this complication should be kept in mind when administering anti-thrombotic therapy prior to endovascular neurosurgery.
