Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is within normal limits . The mediastinal contours again demonstrate a large hiatal hernia projecting to the left lower chest . The right hemidiaphragm is chronically elevated . Between the right hemidiaphragmatic elevation and the left - sided hiatal hernia , the lungs demonstrate bibasilar atelectasis . There is no large pleural effusion or pneumothorax . Clips in the right upper quadrant are compatible with prior cholecystectomy .
    OUTPUT:
    
Large hiatal hernia and bibasilar atelectasis , although underlying pneumonia can not be entirely excluded .