FINDINGS:
Again seen is a large hiatal hernia in the left lower chest causing associated
 relaxation atelectasis.  There is no focal consolidation, pleural effusion,
 pulmonary edema, or pneumothorax.  The visualized portions of the
 cardiomediastinal silhouette are within normal limits.

IMPRESSION:
Large hiatal hernia.  No evidence of acute cardiopulmonary process.