[Verse 1]
Closed loop obstruction — two points blocked, the pressure mounts within
Blood supply gets strangled, ischaemia setting in
Third spacing pulls the fluid, intravascular volume drops
The gut wall loses viability before the surgeon stops
Distension feeds distension, venous outflow first to go
Then arterial collapse — that's when the bowel starts to throw
[Chorus]
Il colon si torce, il lume si chiude —
Mechanical, functional, we diagnose the crude
Volvulus, intussusception, ileus in the queue
Il chirurgo studia — knows exactly what to do
Closed loop, strangulation, third spacing floods the space
Ogilvie fantasma — non c'è ostacolo in place
[Verse 2]
Now separate your ileus from your mechanical block —
Ileus is the orchestra that's lost its ticking clock
Adynamic, diffuse, no transition point to find
Air throughout the colon, clinical and radiographic kind
Ogilvie's the phantom — pseudo-obstruction of the right
Massive caecal dilation without a ligature in sight
Neostigmine the answer when the caecum starts to billow
Colonoscopic decompression if the pharmacology's too shallow
[Chorus]
Il colon si torce, il lume si chiude —
Mechanical, functional, we diagnose the crude
Volvulus, intussusception, ileus in the queue
Il chirurgo studia — knows exactly what to do
Closed loop, strangulation, third spacing floods the space
Ogilvie fantasma — non c'è ostacolo in place
[Verse 3]
Sigmoid volvulus — coffee bean sign ascending on the film
Caecal volvulus flips the right side, takes the epigastric realm
Gastric volvulus, organoaxial — the rarest of the three
Borchardt's triad: retching, can't pass tube, epigastric agony
Intussusception in the adult — always hunt a lead point cause
Lipoma, polyp, tumour — telescoping without pause
Resection over air reduction, malignancy too near
The telescoping invaginates — the word is *invaginate*, be clear
[Bridge]
Now gastroparesis — vagal nerve dysfunction at the gate
Delayed emptying, the scintigraphy confirms the fate
Four hours, solid meal, more than ten percent retained
Domperidone, erythromycin — the motility maintained
Functional dyspepsia — no organic lesion found
Rome criteria defines it, symptoms cycling round
Pelvic floor disorders — rectal prolapse, full thickness descent
Delorme or Altemeier for the frail, abdominal if strength is present
Peritoneoclysis — that rare, resplendent word — means
Irrigating the peritoneal cavity, surgical washing of the scenes
[Chorus]
Il colon si torce, il lume si chiude —
Mechanical, functional, we diagnose the crude
Volvulus, intussusception, ileus in the queue
Il chirurgo studia — knows exactly what to do
Closed loop, strangulation, third spacing floods the space
Ogilvie fantasma — non c'è ostacolo in place