FINDINGS:
There has been interval intubation with the endotracheal tube slightly low
 lying, terminating approximately 2.5 cm from the carina.  An enteric tube and
 side port are within the stomach.  A left chest tube is demonstrated which
 appears kinked within its distal aspect, and tip overlies the left mid
 mediastinal border.  New subcutaneous emphysema seen within the left lateral
 chest wall.  Small left-sided pneumothorax is similar to prior studies with
 calcified scarring noted at the left apex.  There is worsening aeration of the
 left lung base compared to the prior chest radiograph, likely reflective of
 combination of atelectasis and known pleural effusion.  Multiple left-sided
 rib fractures are again noted.

IMPRESSION:
1. Slightly low lying endotracheal tube with tip approximately 2.5 cm from the
 carina.
 2. Enteric tube in standard position.
 3. Left chest tube appears slightly kinked distally with new left lateral wall
 subcutaneous emphysema.  Grossly unchanged appearance of small left
 pneumothorax.
 4. Left basilar opacity likely reflecting combination of atelectasis and known
 pleural effusion.