Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A ventriculoperitoneal shunt is seen projected over the right hemithorax with its distal tip not clearly seen . A left - sided pacemaker is seen with two leads following an expected course to the right atrium and proximal right ventricle , respectively . The left hemidiaphragm is elevated by gas seen in the stomach or bowel . The heart is mildly enlarged . The hilar contours appear normal . The left costophrenic angle is not well visualized but there is no right pleural effusion . There is a small bochdalek hernia seen on the lateral view . There is no evidence of pneumothorax .
    OUTPUT:
    
No evidence of intrathoracic malignancy or acute cardiopulmonary process .