Veterinary Clinical Medicine-I (General and Systemic)

Simultaneous auscultation and percussion in right side

TECHNIQUES FOR DIAGNOSIS OF THE PROBLEMS OF RIGHT SIDE OF THE ABDOMEN

Percussion and auscultation

• Simultaneous percussion and auscultation over the right flank in the normal liver area, by means of the fingers and phonendoscope, discloses the reduction or absence of normal liver dullness in cases of abomasal dilatation and torsion.
• At the onset of dilatation, tympany occurs along the line extending back from the liver, and dullness occur below the line. In an advanced uncomplicated dilatation, the liver is pushed forwards by the dilated abomasums and so the area of liver dullness becomes less than normal and it is anterior to the usual location. Behind this dullness.
  • There is a horizontal limit between an enlarged tympanitic area dorsally and fluid sound ventrally. In case of torsion, the liver is pushed completely away from the rib cage, and the extending abomasums lies between the abdominal wall and liver. So, there is complete absence of liver dullness and a horizontal line divides the right flank between tympanitic sound dorsally and dullness ventrally.
  • Simultaneous auscultation and percussion of the abdomen on the right side can also be used to detect the presence of gas filled viscera. The phonendoscope is placed on the adominal wall and the adjacent area is sharply percussed by snapping the finger against the flank. A drum like resonance or “ping” signifies the presence of an intra-abdominal viscus that contain gas under pressure, (fluid may or may not be present) positioned adjacent to the body wall and lies against a segment of body wall that is sufficiently thin to transmit the sound produced within the viscera.
  • Many organs can be responsible for right side abdominal “ping” in cattle. The presence of “ping” as well as the size and area involved should e noted. The commonly encountered right side conditions are:
    • An atonic coiled colon is the major diagnostic rule out as it is the most common reason for a “ping” on the right side of a cow. Any reason for anorexia in a cow may cause a “ping” originating from the coiled colon. This ping is a small encircled area deep to the last rib. A ping from right displacement of abomasums is usually larger and extends forward to the 10^th rib, while the ping from a caecal dislocation may encompass as large an area as right side displacement “ping” but is located more caudally in the abdomen. Further, rectal examination will confirm the caecal disorder.