FINDINGS:
In comparison with the study of , there is little overall change
 in the appearance of the heart and lungs.  Continued low lung volumes with
 bilateral pleural effusions and compressive atelectasis with some elevation of
 pulmonary venous pressure.  In the appropriate clinical setting, supervening
 pneumonia would have to be considered.
 
 There has been removal of the right chest tube with no evidence of
 pneumothorax.  The intestinal tube has also been removed.