Veterinary Clinical Medicine-I (General and Systemic)

TECHNIQUES FOR THE DIAGNOSIS OF LEFT SIDE ABOMASAL DISPLACEMENT

Simultaneous auscultation and percussion

• This is useful for the diagnosis of left side abomasal displacement. A pinging (metallic) sound is heard on auscultation with phonendoscope over an area between the sixth costochondral junction (point of elbow) to the upper portion of theparalumarfossa, while simultaneously percussing with the handle of the acoustic hammer. This sound is heard only when the phonendoscope lies directly over the displaced organ. Hence, by moving the phonendoscope from point to point noting the presence or absence of the “pinging” sound the approximate size and position of the abomasum can be mapped out.
• The sound may be best described as that of hitting on an empty tin can or the steel drum or a sound of silver striking crystal or like a penny dropping into a well. Some time the person auscultating may have to listen 5-15 minutes before the sound is heard. Also, increasing the intra-abdominal pressure by holding a knee or fist in the flank while using auscultation-percussion may elicit the ‘ping’ if a displacement is present. Similar sound may also occur with a fluid “splashy” rumen or with pneumoperitoneum.
• The “ping” area with displaced abomasums is oval in outline and is smaller than the area of the rumen. Pneumoperitoneum will be associated with a “ping” on both sides of the body and extends caudally to the pelvic inlet area and may be detected dorsally over the lumbar region.
• Not uncommonly, these characteristic sounds will disappear if the cow is transported to a clinic for surgery and reappear in 24-48 hours. Care must be taken to avoid a gas pocket in an atonic distended rumen, by careful percussion.

Auscultation and succussion

• This is also useful to diagnose left side abomasal displacement. Succession is a diagnostic procedure that consists of shaking part of the body to elicit splashing sounds in a cavity or cavities containing both gas and fluid.
• Auscultation with phonendoscope is performed in the aea of the displaced abomasums and at the same time the lower left flank is vigorously pushed in an upward and inward direction.
• In case of abomasal displacement, a loud ringing and splashing sound is heard. They may occur frequently or as long as 15 minutes apart.