IMPRESSION:
Large left pleural effusion has increased, but there is no appreciable
 rightward mediastinal shift suggesting worsening collapse of the left lung
 except for the apex.  Mild right basal atelectasis has increased and there may
 be a small right pleural effusion as well.
 
 Feeding tube with the wire stylet in place ends in the region of the pylorus. 
 Right jugular line ends at the superior cavoatrial junction.  Cardiac
 silhouette is obscured.  There is no pneumothorax.