Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An endotracheal tube terminates 4 .5 cm above the carina . A nasoenteric tube courses below the left hemidiaphragm another view . Small biapical pneumothoraces and layering left pleural effusion . Subtle left perihilar haziness corresponds to a a region of apparent aspiration on outside CT . Severe widening of the paraspinal lines bilaterally , which correlates with extensive mediastinal hematoma seen on the outside hospital CT chest from earlier on the same date . Spinal fracture and left rib fractures are seen to better detail on outside CT .
    OUTPUT:
    
1 . Markedly abnormal widening of the paraspinal lines bilaterally , correlating with extensive mediastinal hematoma seen on the outside hospital CT chest from earlier on the same date . Please correlate with CT to assess for full extent of injuries in the thorax with particular attention to the thoracic spine and aorta . 2 . Small right apical pneumothorax .