Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A new right internal jugular central venous catheter tip is at the cavoatrial junction . The endotracheal tube is now malpositioned with the tip at the carina . The nasogastric tube tip courses through the esophagus , below the diaphragm , off the inferior borders on the film . There has been worsening opacification of the lungs , with ill - defined airspace opacities now noted throughout the left lung , and worsening right perihilar opacities . Additionally , small left pleural effusion is likely new and layering . No pneumothorax is detected . There is , however , new crescentic lucency projecting under the right hemidiaphragm concerning for pneumoperitoneum .
    OUTPUT:
    
1 . Right internal jugular central venous catheter tip at the cavoatrial junction . No pneumothorax . 2 . New crescentic lucency underneath the right hemidiaphragm discerning for pneumoperitoneum . 3 . Malpositioned endotracheal tube with tip now at the carina . 4 . Worsening bilateral pulmonary opacities , left greater in the right which could reflect worsening pulmonary edema and / or aspiration . Small left pleural effusion . Findings discussed by phone with Dr . ___ at 1 : ___ p .m . on ___ .