Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Tip of the right PICC is in a similar position , in the right brachiocephalic vein . Lung volumes are extremely low , with bibasilar consolidations . Small left pleural effusion is presumed . No pneumothorax . Moderate cardiomegaly is stable . The crescentic lucency under the right hemidiaphragm is re - demonstrated , and remains concerning for subdiaphragmatic free air . However , note that due to difficulty with patient positioning , a true upright radiograph could not be obtained .
    OUTPUT:
    
1 . Possible pneumoperitoneum , which should be further evaluated with a left lateral decubitus abdominal radiograph or cross - sectional imaging . 2 . Persistent low lung volumes with bibasilar consolidations . 3 . Chronic severe cardiomegaly .