[Verse 1]
Picture the appendix, two-point-five centimetres wide,
A neuroendocrine tumour creeping toward the base inside,
Mesoappendiceal invasion, that's the flag you cannot miss,
A simple appendectomy won't be enough for this,
Because the margin's compromised, the lymph nodes are at play,
Right hemicolectomy — that's the surgical relay,
NET at the tip, under two, you keep it clean and brief,
But base involvement flips the script, escalate the grief,
Size and site and spread define the operation's scope,
Two-point-five at the base means you're reaching for a rope,
Ileocolic vessels, en bloc resection's what we do,
Oncologic principles demand a broader view.
[Chorus]
B-A-S-E, check the invasion spread,
Two-point-five at the bottom means hemi lies ahead,
N-E-T at the tip, under two, you're fine,
Cross that threshold at the base — you cross the resection line,
Antibiotics versus knife, uncomplicated case,
Weigh the recurrence, patient choice, and document your base,
B-A-S-E — site and size dictate the play,
Surgical curriculum, assess it, lock it, stay.
[Verse 2]
Now shift the scene — a forty-two-year-old presents at A and E,
Right iliac fossa pain, no perforation, CRP at three,
CT confirms appendicitis, walls are thick but clean,
No abscess, no free fluid — uncomplicated on the screen,
You counsel them precisely: antibiotics are a door,
Amoxicillin-clavulanate or cipro plus metronidazole,
Around eighty percent resolve without a surgeon's hand,
But recurrence creeps in — thirty percent across the land,
Within five years they're back again with symptoms just as raw,
So document the dialogue, informed consent's the law,
Laparoscopic appy carries low morbidity,
Definitive, decisive, returns them symptom-free.
[Chorus]
B-A-S-E, check the invasion spread,
Two-point-five at the bottom means hemi lies ahead,
N-E-T at the tip, under two, you're fine,
Cross that threshold at the base — you cross the resection line,
Antibiotics versus knife, uncomplicated case,
Weigh the recurrence, patient choice, and document your base,
B-A-S-E — site and size dictate the play,
Surgical curriculum, assess it, lock it, stay.
[Bridge]
Self-assess your knowledge — pull the cases from your mind,
What's the cutoff for the hemi? Can you call it every time?
Mesoappendiceal spread — that single phrase should trigger you,
Right hemi, lymph node clearance, oncologic residue,
For appendicitis counselling — quote the numbers clean,
Eighty percent antibiotic success, thirty recurrence between,
Patient values, fitness, preference — weave them in your plan,
That's advanced-level reasoning, that's the surgical exam.