Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been interval placement of a nasogastric tube , which enters the duodenum , distal tip not visualized . The right - sided PICC line is unchanged in position . Moderate layering bilateral pleural effusions have increased . The presence of pleural effusions makes it difficult to assess for underlying pneumonia or pulmonary edema . Retrocardiac opacification , possibly due to atelectasis , is unchanged . The cardiomediastinal silhouette is stable .
    OUTPUT:
    
Increased moderate layering pleural effusions , which limits assessment for underlying pneumonia or pulmonary edema . An upright frontal radiograph or chest CT would be helpful . Newly placed enteric tube extends into the duodenum , tip not visualized .