Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Endotracheal tube terminates 4 .6 cm above the carina with the cuff appearing overinflated . There is extensive subcutaneous emphysema throughout the chest , including outlining the pectoralis muscles and within the neck . A small pneumothorax is seen at the base of the right lung . Linear density along the lateral aspect of the right lung represents an underlying skin fold . The cardiac silhouette is normal . There is pneumomediastinum . Coarse interstitial pulmonary markings are noted diffusely , with bronchiectasis and bronchial wall thickening . Blunting of the left costophrenic angle suggests a trace effusion . Lungs are hyperinflated likely due to underlying COPD . Cardiac silhouette size is normal and there is no pulmonary vascular congestion .
    OUTPUT:
    
1 . Endotracheal tube terminates 4 .6 cm above the carina , with the balloon appearing overinflated . 2 . Small right basilar pneumothorax . 3 . Pneumomediastinum and extensive subcutaneous emphysema . CT of the chest is recommended to assess for site of tracheal injury . 4 . Small left pleural effusion .