Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP chest radiograph demonstrates a widened vascular pedicle , different in contour than initial radiograph . Subcutaneous emphysema involving both hemithoraces is again seen . The bilateral chest tubes are in place , but tiny left pneumothorax is appreciated and the left tube still impinges on the mediastinum . No pneumothorax is seen on the right . Mild cardiomegaly is stable . There is no focal consolidation or pleural effusion .
    OUTPUT:
    
Mediastinum remains widened with abnormal contour . Given lack of remote comparison , 6 hour follow - up radiograph is recommended . Findings were discussed by Dr . ___ with Dr . ___ by phone at 10 :47 a .m . on ___ .