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A 72 year old man with a previous history of an emergency abdominal aortic aneurysm repair presented with rigors and recurrent episodes of melaena. Both oesophagoduodenogastroscopy and colonoscopy were unremarkable. Computed tomography with contrast failed to show evidence of a leak. He subsequently underwent a small bowel push enteroscopy which clearly demonstrated erosion of the Dacron graft through the distal duodenal wall with active bleeding. Emergency surgery was undertaken and the fistula successfully repaired.