Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is redemonstration of a complex large hiatal hernia , containing loops of bowel with what appears to be a prominent air - fluid loop of colon , not significantly changed from prior examination . There cardiac silhouette is not well assessed . No large pleural effusion is seen . No focal consolidation concerning for infection . There is no pneumothorax . Old healed right lateral rib fractures are again seen . Degenerative changes are noted in the shoulders bilaterally .
    OUTPUT:
    
No acute cardiopulmonary process .