The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . reatly thickened, nodulated, and rugged. Sometimesseveral tubular or fusiform aneurisms are met with in the same vessel,with healthy portions of tiie arteries between them. From these dilata-tions, sacculated aneurisms not un-commonly spring. On examining thestructure of a fusiform aneurism, itwill be found that it is always com-posed of an uniform expansion andoutgrowth of all the coats of the ar-tery, which are at the same timesomewhat altered in character; thus,the outer coat is thickened, the
The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . reatly thickened, nodulated, and rugged. Sometimesseveral tubular or fusiform aneurisms are met with in the same vessel,with healthy portions of tiie arteries between them. From these dilata-tions, sacculated aneurisms not un-commonly spring. On examining thestructure of a fusiform aneurism, itwill be found that it is always com-posed of an uniform expansion andoutgrowth of all the coats of the ar-tery, which are at the same timesomewhat altered in character; thus,the outer coat is thickened, the middlerigid and inelastic, and the inner onestiffened, rugged, and tuberculated l)ythe deposition beneath it of variousplastic and atheromatous masses. Nocoagula, however, are found in thedilatation,but a fewfllamentary shredsof fibrine are occasionally seen to beattached to the inner wall. The arte-ries that are usually the seats of fusi-form aneurism are the arch of theaorta (Fig. 351), the iliacs, the femo-rals, and occasionally^ the particular form of aneurism oc-VOL. II 3. Fig. 351.—Lar,e Fusiform Aneurism of As-cending Aorta into Pericardium. 34 ANEUEISM. curs most generally in vessels in which the yellow elastic coat is largelydeveloped, and hence is rarely met with in arteries smaller than thefemoral: it occurs, however, in the basilar artery of the brain. The fusiform dilatation, especially when seated in the arch of theaorta, may attain a very considerable magnitude, and may consequentlyexercise very injurious pressure on contiguous parts, thus producinggreat distress and danger of life. It is usuall}- extremelj chronic, in-creasing very slowly, and being compatible with existence for manyyears ; but at last it usually destroys the patient, and may occasiondeath in several ways. Thus, if it be situated in the aorta, the greatmass of blood in the sac may, by impeding the circulation, overpowerthe hearts action, so that it may be unable to
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