August 2, 2006
HAVANNA, CUBA—The intestinal bleeding that forced Fidel Castro to undergo emergency surgery could be serious and life threatening, or could be routine.
The possible causes of the 79-year old Cuban presidents “sustained bleeding" may be ulcers, a colon condition called diverticular hemorrhage, or colon cancer.
From media descriptions of Castro's symptoms it sounds like it could be diverticular hemorrhage. When the sacs inside the digestive tract intersect with an artery in the intestinal tract they can cause bleeding in the lower portion of the intestinal tract-or stomach.
Diverticulosis is an intestinal condition that means there are weakened spots in the lining of the colon that form sacs or pouches which can become inflamed and bleed. Patients generally undergo surgery and have a large section of their colon resected-or removed
Bleeding of the colon could be a possibility, however, routine treatment for a colon bleeding usually requires the less invasive colonoscopy where a tube is threaded through the digestive tract and the bleeding is stopped with heat.
Bleeding ulcers would be treated with acid-blocking drug therapy
Internal bleeding at Castro's age is serious, but not uncommon.
Dr. Stephen Hanauer, chief of gastroenterology at University of Chicago Hospital told The Washington Times in an interview that it is possible that Castro suffered from a perforated ulcer.
“Ulcers are the most common cause of bleeding in the upper intestine, and diverticular disease in the most common cause of bleeding in the lower intestine or colon."
American doctors, including Dr. Hanauer also speculate that Castro could have colon cancer, but add that it would be impossible to determine this unless they had access to Castro's medical records, and tests. Colon cancer is almost always fatal in a man of Castro's age, especially with the complicated surgery to stop the bleeding.
Castro has had some health problems in the past several years. On October 20, 2004 after a public speech Castro fell, shattering his patella-or knee cap and breaking an arm. After being confined to a wheel chair, Castro recuperated in two months, and was back on his feet.
A recent 2005 report said that Castro had Parkinson's disease, which Castro – who turns 80 on August 13- laughed off as a rumor.
On June 23, 2001 while giving a speech in the hot Cuban sun Castro briefly fainted.
Castro stopped smoking his signature Cuban cigars in the 1980s. Cuban cigars are one of Cuba's most important imports that bring in revenues of about $300 million annually.
In March 2003 when Castro accepted a sixth term as the President of Cuba he said “I promise that I will be with you, if you so wish, for as long as I feel I can be useful-and if it is not decided by nature before. Not a minute less and not a second more. Now I understand that it was not my destiny to rest at the end of my life."
Observes have said that Castro looked thinner than normal, and somewhat weary in his last public appearance a week ago which could suggest that whatever the medical condition is, it is serious.
Castro could remain hospitalized for a few days to many weeks. The bleeding could begin anew, or he could have a heart attack or stroke as a result of post operative complications sometimes referred to as a pulmonary embolism.
SOURCES/CONTRIBUTORS: AP WIREREUTERS THE NEW YORK TIMES THE WASHNINGTON TIMES MERCK MEDICAL TABER MEDICAL NEW ENGLAND JOURNAL OF MEDICINE.
By Randy L. Harrington
© Copyright 2006 Randy L. Harrington. ALL RIGHTS RESERVED. Republication or redistribution of this Article, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Randy L. Harrington. For information about serial reproduction, and distribution rights contact the author.
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