Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Small - to - moderate right apical pneumothorax is similar to the prior study allowing for differences in lung volumes , with apical visceral pleural line now below the right third posterior rib level . Moderate right pleural effusion with apparent subpulmonic component also appears similar . Patchy and linear atelectasis in the left retrocardiac region is slightly improved . Left lung and pleural surfaces are otherwise clear . Note is made of moderate - to - marked gastric distension in the imaged portion of the upper abdomen .
    OUTPUT:
    
1 . Persistent small - to - moderate right apical pneumothorax and moderate right pleural effusion . 2 . Gastric distention .