Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The nasogastric tube has been removed with insertion of a PEG . The tracheostomy is in standard position . The remaining support devices are also in standard position . Extensive pneumoperitoneum is new since PICC insertion . Worsening low lung volumes with more basal atelectasis and crowding of the bronchovascular vascular markings . No pneumothorax . The heart size is unchanged .
    OUTPUT:
    
Extensive pneumoperitoneum post PEG insertion , greater than expected . Suggest close clinical follow - up and repeat radiographs .