Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest were compared to previous chest x-ray from ___ and older exams dating back to ___ . Again seen is a large hiatal hernia with air - fluid levels within intrathoracic bowel loops , both on the left and on the right . Where visualized , the lungs are again notable for patchy opacity in the right midlung , grossly uchanged . Assessment for pleural effusions ; however , or lower lobe disease is limited secondary to large hernia .
    OUTPUT:
    
Limited exam given massive hiatal hernia . Possible residual right mid lung consolidation . However , no significant change from prior . CT may be necessary for more detailed evaluation .