                                 FINAL ADDENDUM
  
 Findings were discussed with Dr.   the phone by Dr.  at
 9:01 a.m. on .  The findings were obtained approximately 30
 minutes prior to that.
 
                                 FINAL REPORT
 REASON FOR EXAMINATION:  Evaluation of the patient after bowel resection with
 respiratory distress.
 
 Portable AP radiograph of the chest was reviewed in comparison to .
 
 The ET tube tip is too low, 18 mm above the carina and should be pulled back
 at least 2 cm.  The NG tube tip is at the gastroesophageal junction with the
 sidehole being in the distal esophagus and should be advanced.  Heart size and
 mediastinum are grossly stable, but there is interval development of left
 lower lobe atelectasis and left mediastinal shift.  Bilateral pleural
 effusions appear to be increased and there is also interval development of the
 interstitial prominence, concerning for pulmonary edema.  Potential
 intra-abdominal devices projecting over the upper abdomen are partially
 imaged.  The extreme lucency in the upper lungs and distortion of the lung
 parenchyma is most likely in consistency with emphysema.  Intraperitoneal air
 is partially seen on the current study.
