[Verse 1]
Mucosa herniates through muscle wall defects,
Where the vasa recta penetrate — that's where it wrecks,
Low-fibre diet, raised intraluminal pressure's the cause,
Sigmoid's the commonest site, learn the laws,
Hinchey staging — one through four, classify the spread,
One is pericolic abscess, four means faecal dread,
Modified Hinchey breaks it down even more precise,
WSES adds severity — count the cost, weigh the price
[Chorus]
Diverticular disease, escucha bien,
From the uncomplicated case to the abdomen abierto,
Hartmann's o anastomosis — decide tonight,
La clasificación, the staging gets it right,
Diverticular disease, grábalo en tu mente,
Complicated, simple — treat it competently
[Verse 2]
Uncomplicated case — outpatient route is fine,
AVOD and DIABOLO proved antibiotics don't define
Every single episode — selective use is valid now,
Analgesia, clear fluids, watchful waiting — take a bow,
But complicate the picture — abscess over four centimetres wide,
Percutaneous drainage under CT — that's your guide,
Laparoscopic lavage — LOLA, SCANDIV, DILALA all say
Purulent peritonitis — lavage buys the day
[Chorus]
Diverticular disease, escucha bien,
From the uncomplicated case to the abdomen abierto,
Hartmann's o anastomosis — decide tonight,
La clasificación, the staging gets it right,
Diverticular disease, grábalo en tu mente,
Complicated, simple — treat it competently
[Verse 3]
Faecal peritonitis — Hinchey four demands more grit,
LADIES trial, DIVERTI — primary anastomosis may fit,
Hartmann's reversal rates are low — stoma's often permanent,
So select your patient carefully — ASA score's relevant,
Damage control — pack it, close it, return another day,
When the physiology is broken, staged repair's the way,
Elective resection — wait sixty days from hot attack,
Proximal margin sigmoid cleared, distal at the rectum's back
[Bridge]
Fistulae — the colovesical pneumaturia clue,
Faecaluria, recurrent UTI — that's colovesical too,
Colovaginal fistula, air and stool per vagina,
Stricture causing obstruction needs a plan that's finer,
Bleeding — diverticular, often right-sided, stops alone,
Angioembolisation if it won't leave you alone,
SCAD — segmental colitis associated with disease,
Right-sided diverticulitis — CT confirms, if you please
[Outro]
Now a rare word — fistulous tracts are *anfractuous*,
Winding, tortuous, convoluted — that's what it means to us,
Just like the sigmoid, full of twists and turns,
Classify, resect, anastomose — that's how a surgeon learns,
Splenic flexure mobilisation — tension-free is key,
Diverticular disease — now you know the full decree,
Grábalo, practícalo — la enfermedad diverticular,
Master every pathway, desde simple al quirófano