IMPRESSION:
In comparison with the earlier study of this date, there is little interval
 change.  Extensive subcutaneous emphysema persists along the chest walls and
 into the neck bilaterally as well as in the pectoral muscles. Left chest tube
 is in place and there is no definite pneumothorax. Otherwise, little change in
 the appearance of the monitoring and support devices as well as the heart and
 lungs.