Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is extensive , diffuse bilateral subcutaneous emphysema involving the chest bilaterally , with extension into the neck , superior extent not included on the image . The subcutaneous emphysema extends inferiorly along the bilateral chest walls at least to the upper abdomen , inferior aspect not included on the images . Extensive pneumomediastinum is seen , better assessed on subsequent CT . There are bibasilar opacities which may be due to atelectasis , aspiration , or pneumonia . Subtle lucency at the right costophrenic angle may be due to a small pneumothorax and / or a large bulla . Lucency of the upper lungs bilaterally is consistent with severe pulmonary emphysema .
    OUTPUT:
    
Severe extensive , diffuse subcutaneous emphysema bilaterally , which extends into the neck and abdomen . Pneumomediastinum , better assessed on subsequent CT . Lucency at the right lateral lower chest raises concern for small pneumothorax versus bulla . A right - sided chest tube was subsequently placed . Bibasilar opacities could be due to infection , aspiration , less likely atelectasis .