Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient remains intubated . Positioning of the endotracheal tube appears unchanged . A right - sided PICC line terminates in the superior vena cava . There is again a very large hiatal hernia hernia in which the orogastric tube again terminates . There is similarly a mildly distended viscus within the hernia sac ; a portion of the transverse colon is suspected to reside with in the hernia in addition to a substantial portion of the stomach . There is a suspected small layering pleural effusion on the right with patchy right basilar opacity that is compatible with atelectasis . The pleural effusion appears less prominent , however , but the apparent difference is possibly due to differences in patient orientation . A pleural effusion is difficult to exclude on the left . A left upper lobe opacity has shifted somewhat and appears more flat and dense , layering along the left hemidiaphragm , perhaps more suggestive of atelectasis than pneumonia on this examination . In addition , a retrocardiac opacity opacity also persists in the left lower lobe . There is no pneumothorax .
    OUTPUT:
    
Apparent decrease in right pleural effusion , although possibly due to changes in positioning ; attention in follow - up is suggested . Shift morphology of left upper lobe opacity and similar retrocardiac opacity ; these could be seen with atelectasis although an infectious process is not excluded .