Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is unchanged extensive subcutaneous emphysema as well as pneumomediastinum . A left chest tube is in unchanged position . Presence of pneumothorax is difficult to evaluate given the extensive subcutaneous emphysema but no definite large pneumothorax or mediastinal shift is present . The cardiomediastinal silhouette is unchanged .
    OUTPUT:
    
No significant interval change with extensive subcutaneous emphysema and pneumomediastinum . No definite large pneumothorax or mediastinal shift with left chest tube in place .