[Verse 1]
Pull up the rectal MRI, time to read the scan with precision
T-one stays mucosa-bound, T-two invades the muscular division
T-three breaks the muscularis, fat's the new frontier
T-four hits adjacent organs, perforating what was clear
Now check the mesorectal fascia — threatened means a millimetre near
MRF positive means that margin's compromised, the resection line severe
EMVI — extramural vascular invasion — tumour threading veins
Nodular signal wrapping vessels, that's the tell that systemic spread explains
Stage it sharp, stage it cold, read the sequences with care
T2-weighted axial cuts, the pelvis laid completely bare
[Chorus]
T-stage, MRF, EMVI — read the pelvis like a map
Capsule bleeding, capsule scope — plug the occult gap
ERAS keeps the bowel moving, multimodal attack
Self-assess, recalibrate, no amnesia — come back
[Verse 2]
Negative EGD, negative scope, but the haemoglobin creeps
Occult bleeding's hiding somewhere in the territory between
First manoeuvre — capsule endoscopy, swallow the camera whole
Images every centimetre of small bowel as it scrolls
If capsule finds a lesion, push to device-assisted enteroscopy
Single or double balloon, reach the pathology with dexterity
Angiodysplasia, Dieulafoy, NSAID ulcers, Meckel's diverticulum too
Technetium scan for Meckel's, mesenteric angio if it's acute and bleeding through
CT angiography when haemodynamics start to shake
Map the vessel, find the bleed, then intervention's yours to take
[Chorus]
T-stage, MRF, EMVI — read the pelvis like a map
Capsule bleeding, capsule scope — plug the occult gap
ERAS keeps the bowel moving, multimodal attack
Self-assess, recalibrate, no amnesia — come back
[Verse 3]
Elective colectomy, construct the ERAS from the ground
Prehabilitation first — nutrition, physio, optimise what's found
Preop carb loading two hours out, avoid that fasted state
Multimodal analgesia planned, minimise the opiate weight
Intraoperative — warm the patient, restrict the IV fluid in
Laparoscopic approach preferred, limit the catecholamine spin
Postop — remove the catheter early, mobilise by day one hard
Oral intake within hours, laxatives and gum on the ward
Avoid routine NGT drainage, it slows the gut reboot
DVT prophylaxis, PONV protocol — audit every route
[Bridge]
Here's your rare word, tuck it in — vellichor — that aching pull
To revisit what you barely knew when textbooks felt half-full
Self-assessment is that vellichor, the wistfulness of gaps you've missed
Measure what you don't yet know, then sharpen every fist
MRF threatened or involved? Downstage before the knife
EMVI positive on MRI predicts a harder fight for life
Capsule first for occult bleed, then escalate the tech
ERAS built from evidence, not habit — double-check
[Chorus]
T-stage, MRF, EMVI — read the pelvis like a map
Capsule bleeding, capsule scope — plug the occult gap
ERAS keeps the bowel moving, multimodal attack
Self-assess, recalibrate, no amnesia — come back