The Herald Bleed—A Fortunate Endoscopic Diagnosis of an Aorto‐Duodenal Fistula Secondary to a Mycotic Aortic Aneurysm With Abscess Formation

Aorto-duodenal fistula is a rare but catastrophic cause of gastrointestinal bleeding. A high index of suspicion is required for diagnosis. Reviewing previous imaging provides essential hints. A pulsatile clot or bleeding source can be seen on endoscopy. Management is surgical with multi-disciplinary involvement. Unfortunately, mortality remains high.