IMPRESSION:
Is been no appreciable change since  in residual diffuse
 infiltrative pulmonary abnormality, the vestiges of pneumomediastinum, and
 probable small residual bilateral pleural effusions.  Right pigtail drainage
 catheter, ET tube, and left PIC line are unchanged in their respective
 positions. A nasogastric tube passes as far as the distal esophagus but the
 tip is not clearly seen. There is no pneumothorax.