Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a moderate left - sided pneumothorax . There is flattening of the left hemidiaphragm , bb possible subtle widening of the left rib interspaces and slight mediastinal shift to the right , raising concern for tension . There may be small amount of left pleural fluid . Evidence of pneumomediastinum as also seen . Subtle patchy right base opacity may be due to atelectasis . The aorta is calcified and tortuous . The cardiac silhouette is top - normal .
    OUTPUT:
    
Moderate to large left pneumothorax with concern for underlying tension , as above . Possible small left pleural effusion . Pneumomediastinum .