Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single AP view of the chest was obtained with the patient in semi-upright position . Pulmonary congestion and pleural effusion is again seen , unchanged , left greater than right . The pulmonary vasculature does not show signs of congestion . The PICC line has been adjusted since previous imaging and now is located with the tip 2 cm above the carina . There is no pulmonary edema , chest consolidation . The heart size is unchanged . There is no pneumothorax or other complications noted . As before , there is marked gas distention of the large bowel which raises the question of a possible obstruction or ileus . Followup imaging of the abdomen should be pursued to further evaluate the large bowel . There is no evidence of free abdominal air . The large bowel is much more distended than on previous day .
    OUTPUT:
    
Marked gaseous distention of the large bowel . Recommend followup abdominal radiographs to assess for obstruction or ileus . Pulmonary congestion and effusion is unchanged from imaging earlier today .