Which physical exam finding supports a diagnosis of ruminal tympany on the left side?

• A. A dull, non-painful mass in the right flank
• B. Normal auscultation on the left side
• C. A distinct, resonant tympanic ping felt and heard at the left paralumbar fossa on percussion/auscultation
• D. A heart murmur at the apex

Answer: (C)

Gas distention of the rumen causes a characteristic tympanic sound that can be felt and heard when you percuss and auscult over the left paralumbar fossa, where the rumen sits. This distinct, resonant ping on the left side is the hallmark finding for ruminal tympany because it directly reflects gas within the rumen rather than other abdominal or systemic processes. A dull, non-painful mass in the right flank would point to a different issue; normal auscultation on the left would not explain the gas buildup; and a heart murmur at the apex is unrelated to rumen gas.