FINDINGS:
There has been interval removal of the right-sided central venous
 catheter.  A Port-A-Cath visible on the left has its tip terminating in the
 cavoatrial junction.  An ovoid lucency projects over the right
 tracheobronchial angle and a crescentic lucency is seen along the junction of
 the left heart border and aortic lumen and a small subdiaphragmatic crescentic
 lucency is also seen beneath the right hemidiaphragm.  Subcutaneous emphysema
 is seen along the right chest wall.  Overall, the lungs are clear.  There is
 no large pleural effusion or pneumothorax.  An old healed rib fracture is seen
 in the eighth posterolateral rib on the right.  Clips are seen in the
 epigastric region of the abdomen.

IMPRESSION:
Mediastinal lucencies concerning for pneumomediastinum;
 subcutaneous emphysema; subdiaphragmatic free air, all new compared to prior
 study, and in the setting of recent surgery may reflect air dissecting along
 the fascial planes.  Correlate with other history of instrumentation or
 trauma. An initial report of these findings was given by Dr.  to Dr.
  at 7:00 a.m. in person on .