Effect of infusion chemotherapy and hepatic artery ligation on normal liver: experimental study in the cat.

The effects of arterial infusion with chemotherapy alone or in combination with hepatic artery ligation on the normal liver of the cat were studied. Early in the course of treatment cats receiving chemotherapy infusion only appeared sicker than animals in other groups. Yet only 1 of 5 cats was dead at 12 weeks. In contrast, 4 of 6 animals that had hepatic artery ligation and chemotherapy infusion, and 3 of 6 that had ligation of the hepatic artery only, died during the same period of follow-up. Progressive liver damage after dearterialization accounted for the high mortality rate. Histologic examination of liver biopsies taken from animals in these latter groups revealed marked destruction of the parenchyma. These changes were more extensive in animals treated by a combination of hepatic artery ligation and chemotherapy infusion. To avoid the injurious effects of permanent interruption of the hepatic arterial flow on normal liver tissue an alternative method of hepatic dearterialization is currently under investigation.

Penetrating trauma of the neck.

Two hundred forty-six patients admitted to the Trauma Unit of Cook County Hospital with penetrating neck wounds have been reviewed. A policy of mandatory neck exploration combined with a systematic approach to resuscitation and a diagnostic evaluation including neck and chest X-rays, endoscopy, and arteriography has been employed. The study has revealed a high incidence of negative neck explorations (63%) but minimal morbidity (less than 1%), no mortality, and a brief duration of hospitalization in the negative exploration group. Patients with positive explorations had an 8% morbidity and a 9% mortality rate. In addition, 13 of the patients with positive explorations had clinically negative wounds which might have been overlooked if selective management had been utilized in this series. We conclude that a policy of mandatory neck exploration is justified and advisable for patients sustaining penetrating neck injuries.