Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Low lung volumes are present . Mild enlargement of the cardiac silhouette with a left ventricular predominance is unchanged . The mediastinal and hilar contours are otherwise unremarkable . Pulmonary vasculature is not engorged . Retrocardiac opacification is not substantially changed in the interval , and could reflect atelectasis , but infection is not completely excluded . No large pleural effusion or pneumothorax is detected . Remote right - sided rib fractures are again noted . Diffuse gaseous distention of bowel loops within the upper abdomen are similar to the previous study .
    OUTPUT:
    
Low lung volumes with persistent retrocardiac opacity , possibly atelectasis , though infection is not excluded in the correct clinical setting . Marked gaseous distention of bowel loops in the upper abdomen , as seen previously .