Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Rotated positioning . This limits assessment of the cardiomediastinal silhouette . An ET tube is present , tip in satisfactory position approximately 2 .5 cm above the carina . An NG tube is present . This overlies a rounded focus of air which is thought to represent gas within a large hiatal hernia . There is associated elevation of left hemidiaphragm and overlying left base atelectasis . The left lung apex appears grossly clear . Left mid zone is considerably obscured due to rotation , but the possibility of pleural fluid at the left base can not be excluded . On the right , there is new opacity , particularly in the right mid and lower zones . This in part represents vascular plethora , but the right hemidiaphragm is now obscured suggesting a pleural effusion , with underlying collapse and / or consolidation . No pneumothorax is identified .
    OUTPUT:
    
1 . New opacity at the right lung base , likely a pleural effusion , with underlying collapse and / or consolidation . 2 . Suspect new vascular plethora / early CHF , based on the appearance of the right upper and mid zones . 3 . Large left hiatal hernia , with left lung base atelectasis and pleural effusion . 4 . Limited assessment of the cardiomediastinal silhouette . Allowing for significant rotation , no definite change . 5 . No pneumothorax identified .