Background
Primary aortoduodenal fistula (PADF) is a rare, serious complication of abdominal aortic aneurysm (AAA). Frequently
the diagnosis is missed due to the rarity of disease.
Case description
A 76 year old, Male referred to GIT center in our hospital suffering from severe upper gastrointestinal bleeding and
melena. All investigation appears normal apart from elevated blood urea with 3 sessions of upper GIT endoscopy by
expert GI Physician with no evidence of cause for the bleeding (he put in her mind Dieulaphoy lesion).