Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is a large hiatal hernia with large air - fluid level and adjacent atelectasis . There is slight blunting of the posterior costophrenic angles there may be trace pleural effusions versus atelectasis . Evidence of swallowed pills are seen posteriorly in the hiatal hernia on the lateral view . No focal consolidation is seen . There is no evidence of pneumothorax . Mediastinal contours are unremarkable . Multiple old right - sided rib deformities are again seen .
    OUTPUT:
    
Large hiatal hernia with large air - fluid level again seen . Slight blunting of the posterior costophrenic angles may be to trace pleural effusions versus atelectasis .