Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are normally expanded and clear . There is a large hiatal hernia containing an air - fluid level in the left hemithorax . There is no evidence of pneumonia . The heart is not enlarged . The mediastinal and hilar contours are normal . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
Large hiatal hernia with air - fluid level previously characterized as a paraesophageal hernia by barium esophagram . Please refer to concurrent CT of the abdomen and pelvis for further details .