Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-upright radiograph of the chest demonstrates oblique positioning of the patient . There is a large left - sided basal pneumothorax with associated rightward shift of the mediastinum , raising concern for tension pneumothorax . There may be a small right - sided pleural effusion with adjacent atelectasis . Assessment of endotracheal tube positioning is made difficult based on the patient 's position ; however , the endotracheal tube ends at the level of the clavicular heads . Note is made of gaseous distension of the stomach .
    OUTPUT:
    
1 . Large left - sided basilar pneumothorax with possible rightward shift of the mediastinum raising concern for tension pneumothorax . 2 . Gaseous distension of the stomach ; consider placement of a NG tube for decompression .