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Aortoesophageal fistula involving the distal descending thoracic aorta, filling the distal esophagus and stomach with contrast enhanced blood. Esophagus is thickened and irregular at the site of fistula, but relatively smooth distally. The nonopacified material in the stomach surrounded with contrast likely represents clotting blood from earlier bleeding before the scan.
No acute pulmonary embolus.