Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal silhouette is enlarged which may be exaggerated secondary to low lung volumes . No focal consolidations , pleural effusions , or pulmonary edema are seen . There is significant gastric distention with little evidence of gas in adjacent small bowel loops , raising the question of the gastric outlet obstruction versus gastroparesis . Recommend follow - up abdominal plain film radiography for further evaluation .
    OUTPUT:
    
Significant gastric distention with left with gas in the adjacent small bowel loops raising question of gastric outlet obstruction versus gastroparesis and no evidence of pneumonia or pulmonary edema .