IMPRESSION:
Double tube passes below the diaphragm terminating in the stomach.  Left
 pigtail catheter and right pigtail catheter are in place.  Right PICC line
 terminates in the right atrium and should be pulled back at least 4.5 cm.
 
 Since the prior study the insertion of the left pigtail has Coast substantial
 decrease in left pleural effusion.
 
 Right pigtail catheter is in unchanged position.  There is potentially minimal
 right apical pneumothorax.  No substantial right pleural effusion is be seen. 
 No increase in pleural effusion is seen.