. Annals of surgery. vessel instead of a single sac betweenthe vessels, as is usually found in the disease called varicose aneu-rism. A careful examination made after the specimen has been shrunkenby a years preservation in alcohol, shows the artery and vein justabove the orifice of communication to be of about the same size, butthe wall of the vein is about twice as thick as that of the vessel in its collapsed state measures about a half inch inwidth. The valves of the veins are proportionately hypertrophied. ARTERIO-VENOUS FISTULE OF THE THIGH. 375 Below the orifice of communicat
. Annals of surgery. vessel instead of a single sac betweenthe vessels, as is usually found in the disease called varicose aneu-rism. A careful examination made after the specimen has been shrunkenby a years preservation in alcohol, shows the artery and vein justabove the orifice of communication to be of about the same size, butthe wall of the vein is about twice as thick as that of the vessel in its collapsed state measures about a half inch inwidth. The valves of the veins are proportionately hypertrophied. ARTERIO-VENOUS FISTULE OF THE THIGH. 375 Below the orifice of communication the vein is of practically thesame size as it is above, but the artery is only about one-half as largeas above. The walls of the two vessels have about an equal thick-ness. The vein below the opening is filled with clot, the arteryat the same place is occupied by a small loose clot. The vesselsare now free from clot above. Their original condition is notknown. When the specimen was obtained, gangrene had invaded. Fig. 2.—Diagram of Robertss case of sacculatedarterio-venous fistula. the region in which the lesion was situated, but the vessels had notbeen destroyed. The fistule between the artery and vein is a circular openingabout three-eighths of an inch in diameter, with smooth edges. Thewalls of the two vessels above and below, as well as at the opening,are in close contact, and there is no sac between the artery and vein. 376 JOHN B. ROBERTS. In the side of the vein opposite the fistule is another opening nearlyas large as the fistule. This is the entrance to a sac, with wallsrather thinner than those of the vein, which is lined with a serousmembrane resembling the internal coat of the vein. The sac isoval in shape and has a neck where it opens into the calibre of thevein. Its long diameter measures about an inch, and correspondswith the axis of the vein. Its short diameter is about a half the side of the artery, opposite to the fistulous communication withthe
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
