A sixty-eight-year-old man presented with two episodes of gastrointestinal bleeding in one week. Upper gastrointestinal barium study revealed a tumor in the third part of the duodenum. At operation, the "tumor" was found to be a laminated thrombus that protruded into the duodenal lumen from a primary aortoduodenal fistula. Duodenal repair and aneurysmectomy with Dacron graft replacement were done. The patient was well on follow-up four years after surgery.
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