IMPRESSION:
PA and lateral chest compared to  at 11:03 a.m.:
 
 New feeding tube, without a wire stylet, ends in the mid esophagus just below
 the level of the carina.  Moderate-to-large right pleural effusion is probably
 increased in volume, but comparison is difficult because patient is supine on
 this study, erect on the earlier study today.  Consolidation at both lung
 bases is probably due to worsening atelectasis but of course pneumonia and
 large scale aspiration are not excluded.  Patient is rotated to her left which
 distorts the cardiac silhouette, probably mildly enlarged but unchanged.  The
 left rib fractures are in various stages of healing.  Thoracic aorta is
 tortuous and heavily calcified.  No pneumothorax.  Dr.   I
 discussed these findings by telephone at the time of dictation.