Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left - sided pacer device is seen , stable in position . There is persistent moderate to severe enlargement of the cardiac silhouette . Mediastinal contours are stable . Neo esophagus is again seen , with large air - fluid level distally . There is slight blunting of the costophrenic angles could be due to pleural thickening or trace of pleural effusions . No evidence of pneumothorax is seen . No definite new focal consolidation is seen . Several old right - sided rib deformities are re- demonstrated . Gaseous distention of multiple loops of bowel is incompletely evaluated on this study . .
    OUTPUT:
    
Medial esophagus with large air - fluid level distally . Slight blunting of the costophrenic angles could be due to pleural thickening and / or trace pleural effusions . Cardiomegaly . Gaseous distention of multiple loops of bowel , incompletely evaluated on this study .