Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single AP view of the chest was reviewed . The heart size is top normal . There is no concerning mediastinal widening . The hila are unremarkable . Obscuration of the left hemidiaphragm is likely due to a small effusion with atelectasis . There are displaced fractures of right middle ribs laterally with local pleural or extrapleural bleeding , and fractures of indeterminate chronicity of left third posteriorly , and seventh and eighth ribs posterolaterally , also with local bleeding or pleural thickening . There is no pneumothorax or layering hemothorax . There is no focal consolidation in the right lung ; consolidation , left lower lobe , probably atelectasis , chronicity indeterminate , is partially obscured by the heart . Median sternotomy wires and aortic valve replacement are present . There is no free air under the diaphragm . Spine is scoliotic , but not evaluated by this study .
    OUTPUT:
    
Multiple bilateral rib fractures , acute on the right , possibly chronic on the left , without pneumothorax . Bleeding localized . Spine is scoliotic , but not evaluated by this study . The indication for spinal or additional chest imaging depends upon clinical circumstances .