[Verse 1]
Abdomen cramping, crescendo pain, vomiting bile
Distension rising, bowel sounds echo then go quiet a while
Adhesions top the list — that post-op scar tissue that binds
Then hernia, malignancy, Crohn's inflaming the lines
Gallstone ileus, the stone migrates through a fistula track
Bezoar blocking the lumen, intussusception folding back
Check the history, press the belly, listen then percuss
Tachycardia, fever, peritonism — that's ominous
[Chorus]
Obstrução — closed loop on the CT screen
Mesenteric edema, pneumatosis in between
Reduced enhancement means the blood supply's withdrawn
Adhesiolysis, assess viability, keep the bowel on
Obstrução — não pode esperar
Bologna guidelines mapping when to go to theatre
[Verse 2]
CT scanning is the cornerstone, axial cuts reveal
Transition point, dilated loops, the whirl sign — that's the deal
Closed loop's a surgical alarm — two points, one band, one twist
Pneumatosis intestinalis — air in the wall, don't miss
Mesenteric edema, fat stranding, venous thrombosis near
Reduced mural enhancement — ischaemia becoming clear
ICG fluorescence lights the tissue like a lantern in fog
Doppler pulses through the mesentery, add it to your log
[Chorus]
Obstrução — closed loop on the CT screen
Mesenteric edema, pneumatosis in between
Reduced enhancement means the blood supply's withdrawn
Adhesiolysis, assess viability, keep the bowel on
Obstrução — não pode esperar
Bologna guidelines mapping when to go to theatre
[Verse 3]
Non-operative management — NG tube, fluids, observe
Gastrografin challenge at twenty-four hours, watch the curve
If contrast hits the colon, non-op wins the day
Fail to progress by thirty-six — the surgeon leads the way
Bologna says: strangulation, peritonism, you go straight
No fever, no tachycardia — a trial is appropriate
Laparoscopic first if one prior band is your suspicion
Converted open if the density defeats your incision
[Bridge]
Early postoperative SBO — tricky to decode
Ileus mimics obstruction on the early post-op road
Wait and watch past four weeks, CT only when you must
Reoperate if septic or if ischaemia you distrust
Malignant obstruction — prognosis shapes the plan
Stenting bridges resection, palliative tubes for the terminal man
Sepulchral gut, quiescent — that's a rare word, mark it well
Lifeless yet contained — a bowel that's ischaemic won't compel
Second-look laparotomy: return at forty-eight
Reassess the marginated loops before you resect and wait
Bioresorbable membranes wrap the anastomosis tight
Adhesion prevention — Seprafilm, meticulous haemostasis right
[Chorus]
Obstrução — closed loop on the CT screen
Mesenteric edema, pneumatosis in between
Reduced enhancement means the blood supply's withdrawn
Adhesiolysis, assess viability, keep the bowel on
Obstrução — não pode esperar
Bologna guidelines mapping when to go to theatre