Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable and stable since the prior examination . Again seen is a large left - sided hiatal hernia containing bowel causing apparent elevation of the left hemidiaphragm . The lungs are grossly clear . There is no pleural effusion or pneumothorax . No definite fracture is identified .
    OUTPUT:
    
Stable , large left hiatal hernia without acute intrathoracic abnormality .