Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lung volumes are very low and appear slightly decreased since ___ . Opacity in the right upper lobe silhouettes the right paratracheal stripe , however , this appears relatively unchanged since the ___ . There is mild pulmonary vascular congestion . No pneumothorax or large pleural effusion identified . The aorta is tortuous . The heart size appears stable . A large left diaphragmatic hernia contains loops of bowel and appears similar in size since ___ . The bones are demineralized . There are old right rib fractures .
    OUTPUT:
    
No new opacity or large pleural effusion . Stable large left diaphragmatic hernia and mild pulmonary vascular congestion .