Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is stable positioning of an ET tube and an enteric tube . Left internal jugular line is again seen at the junction of the SVC and brachiocephalic vein . A left chest tube is also seen in standard position . Cardiomediastinal and hilar contours are stable . There is no pneumothorax . Again seen is a small left pleural effusion with left retrocardiac opacity . Multiple consecutive rib left lateral rib fractures are again noted .
    OUTPUT:
    
No significant interval change . Multiple consecutive segmental left rib fractures with left pleural effusion and left retrocardiac opacity again raises the concern for flail chest .