Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The inspiratory lung volumes remain low with an unchanged large hernia containing bowel in the left hemi thorax . Right middle lobe atelectasis is slightly improved from the most recent prior study . No other focal consolidations are noted . There is no increase in size of a small right pleural effusion . There is no overt pulmonary edema . No pneumothorax is present . The cardio mediastinal silhouette is incompletely evaluated but likely within normal limits and unchanged . Again there is a large hiatal hernia with mildly distended contents but unchanged .
    OUTPUT:
    
Slightly improved right middle lobe atelectasis . Otherwise , unchanged appearance of the chest including large hiatal hernia with mildly distension of contents . Clinical correlation is recommended regarding the current clinical relevance of the finding .