Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Extensive subcutaneous air involving the left chest wall which shows interval progression with air also seen in the right supraclavicular area . Left - sided pigtail drain in situ . Large residual pneumothorax again visualized appearing similar in size compared to imaging done at 06 :39 today . No mediastinal shift to suggest tension effect . Emphysematous changes seen in the right lower lung zone in keeping with history of alpha 1 antitrypsin deficiency .
    OUTPUT:
    
No significant interval change in the size of the left - sided pneumothorax . Interval progression of the subcutaneous air now also visible in the right supraclavicular area .