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Last spring, I was at home washing my hands, and as I glanced up into the mirror, I noticed something unusual. My bathroom light hit my neck just right as I swallowed and there it was: a prominent lump. I diagnosed myself with a thyroid nodule and wondered how I, a physician, had failed to notice this large protuberance before that moment. Thyroid nodules are quite common. In some cases, they are noticed by the patient (like me) or are found on exam. In many cases they are found on accident when someone has an imaging test like a CT scan, MRI,...
Recently I saw a patient who had experienced two consecutive days of pain in his right upper abdomen. I questioned him, looking for clues of gallstones, liver mass, or maybe an ulcer in the small bowel, but his answers did not fit my expectations. The pain was located under his right ribs and radiated into his back, just as I would expect of gallbladder disease; but it was not triggered by eating, and the way the patient described the pain did not fit the profile of an abdominal disorder. Then, a lightbulb went off; I needed to look at his...
