Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single frontal view of the chest was obtained . Large subdiaphragmatic lucency appears to outline the diaphragm and the liver , and may represent a large pneumoperitoneum or a markedly distended viscous such as stomach or transverse colon . Endotracheal tube has been replaced with a tracheostomy tube . Right internal jugular central catheter terminates in the distal SVC . Sternotomy wires are intact . Moderate to large right and moderate left pleural effusions are slightly enlarged since prior with similar bibasilar opacities . Cardiomediastinal contours are stable with mild cardiomegaly .
    OUTPUT:
    
1 . Large subdiaphragmatic lucency may represent pneumoperitoneum related to recently placed PEG or a markedly distended viscous . Dedicated abdominal radiograph could differentiate between these entities . 2 . Status post tracheostomy placement . No pneumothorax . 3 . Slight interval enlargement of moderate - to - large right and moderate left pleural effusions . Findings were communicated via phone call by Dr . ___ to ___ , NP , on ___ at ___ PM , 5 minutes after discovery of the findings .