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ss nucleus - spring 1993,  Differential Diagnosis 3

Differential Diagnosis 3

Acts 12:23

The gospel writer Luke and the Jewish historian Josephus give us only sketchy details of Herod Agrippa's death, but there is enough information to make a reasonable diagnosis. We are told that the disease process involved worms and was characterised by severe abdominal pain leading to death in five days. The large round worm Ascaris lumbricoides is the likely pathogen. Heavy infestation of the intestinal tract by this parasite commonly leads to small bowel obstruction, which may be complicated by volvulus, gangrene, perforation and peritonitis. The symptoms and time course of the Jewish king's fatal illness are consistent with this sequence of events.

Differential Diagnosis 4

King Jehoram of Judah was afflicted by God with a 'lingering disease of the bowels'. We read that 'in the course of time, at the end of the second year, his bowels came out because of the disease, and he died in great pain' (2 Ch 21:15, 18-19). From the description, what was the probable underlying pathology and the complication that led to his death?

Luke's opinion in the next issue.

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