# Transnasal Esophagorumenoscopy and Laparoscopic Assisted Rumenostomy in a Cow With Digestive Distress—Case Report

## TL;DR

A cow with digestive issues was examined using endoscopic techniques, which helped diagnose and temporarily manage the condition, though the cow ultimately died from severe complications.

## Contribution

This case report demonstrates the combined use of transnasal endoscopy and laparoscopic rumenostomy in diagnosing and managing digestive distress in cattle.

## Key findings

- Transnasal esophagorumenoscopy identified esophageal ulcers but no obstruction.
- Laparoscopic rumenostomy revealed ruminal impaction and peritoneal adhesions.
- The procedures provided short-term stabilization but could not reverse severe pathology.

## Abstract

A Girolando cow presented with signs suggestive of esophageal obstruction. The team performed diagnostic and therapeutic procedures. Transnasal esophagorumenoscopy with a flexible gastroscope revealed hyperemic erosions and later foamy ulcers in the esophageal mucosa, but no obstructive foreign body. Laparoscopic‐assisted rumenostomy via a two‐port technique identified intraperitoneal adhesions and ruminal impaction. Under laparoscopic guidance, we placed and secured a handmade cannula fashioned from a 10‐mm cuffed endotracheal tube to the abdominal wall. This provided access for therapeutic transfaunation and fluid administration, facilitating short‐term clinical stabilization. However, the cow ultimately died due to complications from traumatic reticuloperitonitis caused by a perforating metallic foreign body, leading to diffuse peritonitis and aspiration pneumonia, as confirmed by necropsy. The primary sequelae were diffuse peritonitis and aspiration pneumonia, the latter likely secondary to the esophageal dysfunction and/or therapeutic intervention, as confirmed by necropsy. Despite the fatal outcome, transnasal endoscopy offered valuable real‐time assessment of esophageal integrity, and the laparoscopic‐assisted placement of a ruminal cannula proved to be a functional, minimally invasive therapeutic alternative. This case illustrates the combined utility of these endoscopic techniques for diagnosing and managing complex digestive distress in cattle, while highlighting their limitations in reversing severe, established pathology.