Detection of neck hematoma after carotid endarterectomy by chest X-ray

A 61-year-old man presented to the emergency room with left hemiparesis and dysarthria. Brain magnetic resonance imaging showed right middle cerebral artery territory infarction with proximal internal carotid artery stenosis. Carotid endarterectomy (CEA) was performed on the 8th day of admission. After 3 hours of CEA, the patient complained of dyspnea, and stridor was developed. Chest X-ray was performed immediately (Fig. 1), and emergent endotracheal intubation was performed under suspicion of airway obstruction due to hematoma. Neck computed tomography (CT) confirmed hematoma formation around the carotid vessels (Fig. 2). Blood pressure was strictly controlled without discontinuation of clopidogrel, and hematoma was noted to Fig. 1.