Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is intubated . The endotracheal tube terminates approximately 4 cm above the carina . An orogastric tube terminates near the inlet of the diaphragm . A right internal jugular venous catheter terminates in the superior vena cava . There is again moderate unfolding of the thoracic aorta . Surgical clips also project over the lower - to - mid mediastinum . Mediastinal widening is consistent with post-operative change . There is new confluent left basilar opacification suggesting atelectasis in the left lower lobe of substantial extent with a pleural effusion , probably small to moderate in size . A small subpulmonic right - sided pleural effusion is difficult to exclude . There is also subcutaneous emphysema , small in amount , along the right lateral chest wall , as well as a right - sided chest tube . The patient is status post incompletely characterized lower cervical fusion . Moderate degenerative change involves the right shoulder .
    OUTPUT:
    
Lines , tubes and drains as described above with post-operative changes , including post-operative mediastinal widening and left lower lobe opacification with a pleural effusion .