IMPRESSION:
Duct of tube passes below the diaphragm most likely terminating in the
 stomach.  TIPS is in place.
 
 Since the prior study there is interval increase in pleural effusion,
 currently large with left mediastinal shift.  Underlying most likely
 compression atelectasis of the right lung is present.  There is no changes in
 the left lung demonstrated.
 
 RECOMMENDATION(S):  Third paracentesis to be considered if clinically
 indicated giving the substantial compression of the right lung by increase in
 right pleural effusion.