Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single upright frontal image of the chest again demonstrates a large amount of gas overlying the mid upper abdomen , which may represent extensive stomach distention or pneumoperitoneum . Given the urgency of these findings , it is recommended that the patient have an NG tube placed for stomach decompression and then it is recommended that a repeat upright chest radiograph be obtained to rule out pneumoperitoneum . There are no cardiac or pulmonary changes since the prior examination .
    OUTPUT:
    
Large amount of air continues to overlie the abdomen and could represent distended stomach or possibly pneumoperitoneum . Recommend urgent placement of an NG tube for stomach decompression followed by urgent upright chest radiograph to rule out possible pneumoperitoneum . Otherwise , unchanged pulmonary and cardiac findings . These findings were made at 11 :45 a .m . on ___ and were communicated to Dr . ___ at 11 :46 a .m . on ___ by telephone .