Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Pacer is seen in the left anterior axillary position with intact leads along the expected course to the right atrium and right ventricle . There is a large hiatal hernia on the left , which includes a visible air - fluid level within the stomach . The lungs are well expanded and clear . There no pleural effusion . There is no pneumothorax or other related complication . Cardiomediastinal silhouette is partially obscured by the hiatal hernia , but appears unchanged from prior exam .
    OUTPUT:
    
Pacer leads in appropriate position . Large hiatal hernia on the left .