Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Evidence of a large diaphragmatic , hiatal hernia is again seen with intrathoracic stomach and loops of bowel . There is slight blunting of the left costophrenic angle and there may be trace pleural effusion . Retrocardiac opacity likely relates to large hiatal hernia with associated atelectasis . Underlying consolidation is not excluded although felt less likely . Cardiac and mediastinal silhouettes are stable . Diffuse osteopenia .
    OUTPUT:
    
Evidence of a large diaphragmatic , hiatal hernia is again seen with intrathoracic stomach and loops of bowel . There is slight blunting of the left costophrenic angle and there may be trace pleural effusion . Retrocardiac opacity likely relates to large hiatal hernia with associated atelectasis . Underlying consolidation is not excluded although felt less likely .