FINDINGS:
There are low inspiratory volumes. The cardiomediastinal silhouette is
 unchanged. There is increased opacity at the left base, consistent with left
 lower lobe collapse and/or consolidation, possibly slightly worse. There is
 upper zone redistribution and mild vascular blurring, progressed from the
 prior film. The right lung base in costophrenic sulcus are grossly clear,
 except for subsegmental atelectasis. No pneumothorax is detected.
 
 Again seen are the rib fractures along the left upper chest wall. There is a
 small amount of newly visible pleural thickening in this area, consistent with
 edema/hemorrhage.

IMPRESSION:
1. Left lower lobe collapse and/or consolidation, possibly slightly worse. The
 possibility of superimposed aspiration would be difficult to exclude.
 2. Mild CHF, increased compared with .
 3. Left-sided rib fractures again noted, now with slight associated pleural
 thickening.