Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A very large hiatal hernia is once again seen . At the left lower lung lung there is a streaky opacity which is likely atelectasis . The right lung is clear . There is no pneumothorax . The bones appear grossly intact . The cardiomediastinal silhouette is difficult to assess secondary to the large hiatal hernia .
    OUTPUT:
    
Streaky opacity in the left lower lobe adjacent to the large hiatal hernia , most consistent with atelectasis .