A 60-year-old man presenting with acute myocardial infarction was treated by emergency percutaneous coronary intervention(PCI)and initiation of dual antiplatelet therapy(DAPT)with prasugrel and aspirin. On the sixth hospital day, a rapid decrease of the blood hemoglobin level and black stools were detected. Upper and lower gastrointestinal endoscopies neither revealed the source of bleeding nor any clear causative disease. As the anemia continued to worsen, contrast-enhanced abdominal computed tomography was performed, which revealed a hypervascular mass in the jejunum measuring 3 cm in size. As the patient had just undergone PCI, it was essential to continue the antiplatelet therapy, while emergency surgery was needed to achieve control of the bleeding. Partial resection of the small intestine was performed with single-hole laparoscopic assistance using the umbilical approach. The patient was discharged eight days after the surgery without any notable cardiovascular events or perioperative complications. Massive gastrointestinal bleeding associated with the use of antiplatelet drugs is a challenging abdominal emergency, and it is necessary to balance management of the primary disease with the surgical invasiveness. Early surgical intervention may be effective for achieving both control of the gastrointestinal bleeding and avoiding stent restenosis, and minimally invasive surgery with single-hole laparoscopic assistance may be acceptable.