TRAUMATIC ANEURYSMS AND ARTERIOVENOUS FISTULA

Posttraumatic pseudoaneurysms and arteriovenous fistula are rarely observed(1) where time from trauma to diagnosis varies from hours to years. Because of the imminent clinical course, early operation is usually indicated to prevent very impressively the extensive consequences of an unrecognized traumatic AV malformation(2). They occur most commonly in the extremities and are noted most often in military casualties. (3) The trauma leading to the AVM may be penetrating, blunt, postsurgical or inflammatory. A swelling with or without pulsation, loss of function or peripheral claudication of the limb are the main presenting symptoms. A bruit and trill are usually present. Color Doppler USS and CT angiography will provide the essential diagnostic information. In our research there are 12 cases of traumatic AVM in different parts of the body which are angiographically documented. The surgical procedures performed were proper identification of feeder vessels, surgical control of these vessels, excision and arterial ligation and total excision and end to end arterial anastomosis or by grafting when segmental resection is required, either by reversed autogenous vein graft or by synthetic graft remain the basic principles of therapy. The end result of the surgical operations was considered good in most of patients with restoration of normal blood flow to the affected limb.