Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Large hiatal hernia containing bowel is again noted . The hernia again obscures the left lower lobe , left heart border , left cardiophrenic angle , limiting assessment in these regions . Given this , no large pleural effusion is seen . No definite new focal consolidation is seen since the prior study . No pneumothorax is seen .
    OUTPUT:
    
Low lung volumes . Large hiatal hernia again seen . Grossly , no significant change from the prior study .