Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The right lower mediastinal contour , with associated parenchymal opacification , shows renewed prominence which may indicate dilatation of the gastric pull - up , increased atelectasis associated with the contour abnormality caused by the pull - up , or perhaps combination of both . Particularly given that other areas of the lungs appear clear , aspiration pneumonitis is doubtful as the etiology . There is no pleural effusion or pneumothorax . A lower thoracic compression deformity appears unchanged .
    OUTPUT:
    
Increased right lower mediastinal contour suggesting a dilatation of gastric pull - up , increased atelectasis associated with contour abnormality due to the pull - up or both ; this type of appearance appears to have waxed and waned on prior films . Obstruction of the pull - up is a possibility to consider clinically in the setting of recent vomiting .