[Verse 1] Transmural inflammation, skip lesions on the map From mouth to anus, cobblestoning fills the gap Steroids first to cool the flare, short-term bridge the blaze Immunomodulators next — azathioprine for days Anti-TNF biologics, infliximab's the name Anti-integrin vedolizumab, anti-IL plays the same JAK inhibitors rounding out the pharmacologic chain But when the bowel starts to scar and stricture — medicine's in vain [Chorus] Doença do intestino — conserva o que é seu Fístula, estenose, abscesso — know what surgery's due Enfermedad que regresa — keep the margins tight Strictureplasty saves the gut when resection isn't right Bowel conservation — that's the cardinal rule Doença de Crohn, the surgeon's ultimate school [Verse 2] Stricture blocking passage, Heineke-Mikulicz is first Transverse the longitudinal cut when single segments burst Finney for the longer stretch, Michelassi for the isoperistaltic Side-to-side for multiples — the technique is fantástic Ileocolic resection when the terminal ileum fails Kono-S anastomosis — antimesenteric rails Mesentery excluded from the join to cut recurrence down Perforating versus stricturing — the phenotype wears the crown [Chorus] Doença do intestino — conserva o que é seu Fístula, estenose, abscesso — know what surgery's due Enfermedad que regresa — keep the margins tight Strictureplasty saves the gut when resection isn't right Bowel conservation — that's the cardinal rule Doença de Crohn, the surgeon's ultimate school [Verse 3] Abscess first — drain it percutaneous, cool the septic tide Resect electively later when the inflammation's dried Enterocutaneous fistula — control the source upstream Enteroenteric — symptom-driven, rarely what it seems Enterovesical gives you pneumaturia, fecaluria too Cystoscopy confirms it, then you plan what you must do Perforation, bleeding, neoplasia — urgent knife is called Failure of medical therapy — every option stalled [Bridge] Rutgeerts score post-op — endoscopy at one year Zero to four, the higher grades, recurrence drawing near Prophylactic therapy starts when anastomosis heals Perioperative — hold the biologics, nutritional appeal Optimize before you cut — malnourishment is furtive That word means secretly destructive, working covert, subversive Steroids taper pre-op, sepsis must be cleared A quiescent field of battle is the canvas that's revered [Chorus] Doença do intestino — conserva o que é seu Fístula, estenose, abscesso — know what surgery's due Enfermedad que regresa — keep the margins tight Strictureplasty saves the gut when resection isn't right Bowel conservation — that's the cardinal rule Doença de Crohn, the surgeon's ultimate school
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