King Jehoram's intestinal disease was characterised by chronicity, prolapse and death in great pain at the relatively young age of 40. Severe bacillary dysentery may result in prolap&e but is usually not chronic, while inflammatory bowel diseases such as Crohn's and Ulcerative colitis are chronic but don't cause prolapse. Sigmoidorectal intussusception is not often accompanied by prolapse in young patients while chronic rectal prolapse is usually secondary to muscular degeneration in the elderly and rarely results in strangulation. Luke therefore favours either amoebic dysentery with acute rectal prolapse and strangulation or alternatively strangulated internal haemorrhoids with supervening septicaemia.
Differential Diagnosis 5
1 Ki 13:1-6When reprimanded for idolatry by a prophet of Judah, King Jeroboam of Israel responded aggressively and ordered him to be seized. However we read that 'the hand he stretched out towards the man shrivelled up, so that he could not pull it back'. What are the possible diagnoses? Which is most likely and why? What was the outcome in this case?
Luke's opinion in next issue.