For vagal indigestion type 2, which surgical intervention is described?

• A. Rumenotomy
• B. Rumen fistula
• C. Aggressive IV fluids
• D. Prokinetics

Answer: (A)

Vagal indigestion type II creates a functional obstruction of rumen outflow because the rumen’s contractions and forward movement are impaired by vagus nerve dysfunction. The most effective way to immediately relieve this obstruction and assess the rumen is to open it surgically and evacuate the contents—a rumenotomy. This decompresses the distended rumen, removes any longstanding ingesta that may be contributing to the blockage, and gives the surgeon a chance to evaluate the reticulorumen for other lesions or sources of obstruction, which can be crucial in a disease where motility is the primary issue.

Rumen fistulation, while useful for ongoing access and sampling, is a more permanent alteration that isn’t the quickest or most direct way to relieve acute distension in this setting. Aggressive IV fluids and prokinetics address dehydration or stimulate motility but don’t adequately fix an outflow problem caused by neural impairment, especially when there is substantial ruminal distension.