The Cardinal underwent an upper endoscopy and a flexible sigmoidoscopy at 10 a.m. this morning because he passed some blood in his stool earlier today and had a moderate drop in his hematocrit. There was no evidence of a bleeding source in the stomach, duodenum or proximal jejunum (upper GI tract). The sigmoidoscopy revealed no site of bleeding in the left side of the large bowel.

Throughout the morning and the procedure, the Cardinal's vital signs were stable. Given that the common sites of bleeding have been ruled out, it is felt likely that the bleeding this morning represents venous bleeding at the site of the small bowel anastamosis (where the two pieces of the small bowel were joined together after a section was removed to create the neobladder). This type of bleeding is usually minor and usually stops on its own. The most prudent course is deemed to be watchful waiting and careful monitoring. This anastamotic bleeding is not related to the bleeding noted immediately after the Cardinal's cancer operation. It should be noted that the ileal anastomosis (the connection between the two loops of small bowel) appears to be working well. The Cardinal has no fever, he has some abdominal pain localized to the area of the incision but no sign of an abdominal infection (peritonitis), and his white blood count remains completely within the normal range.

Both the Cardinal and all those who care for him are frustrated at this setback. This type of bleeding is a known but infrequent complication. This will push back the plan for discharging the Cardinal, but should not have any effect on his full resumption of duties in the future. Continued prayers are asked for a rapid resolution of this problem.