Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Evidence of a large hiatal hernia is seen . The patient is rotated somewhat to the left . No definite new focal consolidation is seen . There is no pleural effusion or pneumothorax . The cardiac and mediastinal silhouettes are stable . Chronic changes at the shoulder joints are similar to prior and only minimally imaged on the left .
    OUTPUT:
    
Large hiatal hernia with likely adjacent atelectasis . No definite new focal consolidation . No pulmonary edema .