Numerous cases of traumatic arteriovenous fistula in which cure was obtained by surgical measures have been recorded in the literature. The abnormal physiologic effects produced by this condition have been thoroughly studied and reported by Reid,1 Holman,2 Makins3 and Matas,4 to whose writings the reader may refer. Large fistulas involving the major arteries and veins when allowed to persist result in gradual cardiac hypertrophy, dilatation and finally failure, and if they are not corrected death results. The first symptom that may develop is gradually increasing dyspnea on exertion. This is a warning of impending cardiac decompensation that should not be ignored.
The diagnosis of an acquired arteriovenous fistula is not difficult in the majority of cases. In an extremity a pulsating expansile mass is found in the region of the fistula. The limb frequently enlarges and on its surface many large engorged pulsating veins are seen.