[Verse 1]
CT scan on the lightbox, read it like a scripture,
Adhesive SBO — now paint the clinical picture,
Transition point identified, proximal loops distended,
Closed loop pattern, mesenteric twist — blood supply suspended,
Pneumatosis, portal gas, or free air in the cavity,
These findings tip the scales away from watchful passivity,
But isolated partial obstruction, no ischaemic sign?
NG tube, IV fluids, and a forty-eight hour line,
Assess yourself — do you know exactly where to draw it?
Operative versus non-op, can you reason through before you saw it?
[Chorus]
Знаємо знаки, читаємо скани — (we read the signs, we read the scans)
Застрягло, стиснуто — хто виживе, хто впаде?
Ми хірурги, перевіряємо себе знову —
Assess the gut, assess your mind, перевір свою основу
(Check your foundation)
CT findings, fistula, Crohn's — assess yourself, lock it in your bones
[Verse 2]
Thirty years old, multiple strictures scattered through the jejunum,
Crohn's disease has mapped its war across the proximal ileum,
Strictureplasty, Heineke-Mikulicz — preserve the absorptive length,
Bowel conservation is the cardinal, the source of surgical strength,
Finney technique for the longer ones exceeding five centimetres,
Resection reserved for phlegmon, fistula, or failed parameters,
Assess yourself — could you plan this without hesitation?
Nutritional optimisation first, then meticulous resection,
Short bowel syndrome lurks if you cut too bold and free,
Self-assessment here means knowing what you cannot let it be
[Chorus]
Знаємо знаки, читаємо скани —
Застрягло, стиснуто — хто виживе, хто впаде?
Ми хірурги, перевіряємо себе знову —
Assess the gut, assess your mind, перевір свою основу
CT findings, fistula, Crohn's — assess yourself, lock it in your bones
[Bridge]
Here's a word your textbooks rarely pause on — *borborygmus* —
That rumbling, percussive roar the dilated gut throws among us,
Hear it? Name it. Own it. That's your clinical instrument,
High-output fistula screaming through a wound — that sound is eloquent,
Оцінюй, не панікуй — (assess, don't panic)
Sepsis first, then skin, then tract — sequential, systematic, sonic
[Verse 3]
Enterocutaneous fistula — a surgical labyrinth entire,
SNAP is your mnemonic: Sepsis, Nutrition, Anatomy, Procedure,
Control sepsis, drain the collections, antibiotics directed,
Protect the wound with stoma bags — effluent intercepted,
High-output means over five hundred mils each rolling day,
TPN and somatostatin analogues to slow that bilious spray,
Six weeks minimum before you image, fistulogram the tract,
Identify the anatomy — is it end or lateral? Exact,
Then define what stops spontaneous closure — FRIEND is your guide:
Foreign body, Radiation, Infection, Epithelialisation inside,
Neoplasm or Distal obstruction — if these features reside,
Surgery's the answer: resect the segment, restore with pride,
Assess yourself at every phase — do your decisions coincide?