Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Multiple lines , leads and tubes overlie the chest . One may represent an epidural catheter . Again seen is a right chest tube , similar in configuration . Compared with the study from one day earlier , there has been progression of subcutaneous emphysema across the chest , which obscures fine detail . Extensive subcutaneous emphysema is also seen on both sides of the neck and over in the right - greater - than - left supraclavicular regions . Allowing for this , no obvious pneumothorax is detected . The defect in the right upper posterior rib is again noted , likely postsurgical . Patchy opacity in the right cardiophrenic region is more pronounced . No gross right effusion is identified . Some focal opacity in the right upper zone laterally is noted -- if real , this is new , but it could represent artifact due to the presence of the subcutaneous emphysema . On the left , there is minimal atelectasis at the left lung base in the retrocardiac region , with slight blunting of left costophrenic angle . Left lung is otherwise grossly clear . No findings suggestive of CHF on the left .
    OUTPUT:
    
1 . Left chest tube again noted . Increased subcutaneous emphysema , but no obvious pneumothorax . 2 . Opacity in right upper zone laterally -- ___ artifact versus new focal opacity . Attention to this area on followup films is requested . 3 . Small patchy opacity in the right cardiophrenic region , more pronounced than the film from one day earlier .