Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A portable frontal chest radiograph again demonstrates an enlarged cardiomediastinal silhouette . The right lung is fairly well - aerated . The left lung demonstrates decreased aeration and increased pleural effusion . 2 left chest tubes are in place . Of note , the side port of the superior chest tube is extra thoracic , within the soft tissues of the chest wall . There is a small amount of subcutaneous emphysema in the soft tissues of the left neck . The visualized upper abdomen is unremarkable .
    OUTPUT:
    
1 . Decreased aeration of the left lung with increased left pleural effusion . 2 left chest tubes are in place , with the side port of the superior chest tube extra thoracic , within the soft tissues of the chest wall . 2 . Small amount of subcutaneous emphysema in the soft tissues of the left neck .