Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: When compared to prior , there has been no significant interval change . Large left hiatal hernia occupying the left lower hemithorax is again seen . The left upper lung and right lung are clear without focal consolidation or pneumothorax . There is no obvious pleural effusion . Cardiac silhouette is difficult to assess given hiatal hernia . Deformities of the right lateral ribs were present on prior exam and likely due to old fractures .
    OUTPUT:
    
Large left hiatal hernia . No definite superimposed acute cardiopulmonary process .