Action Wall

Introduction The vein gradually expands, the distal end can reach the last valve, and the proximal end can reach the vena cava. If the pupil is large, the pressure in the vein increases suddenly. After a few weeks of trauma, a local pulsatile mass is formed due to venous expansion, which is like a pseudoaneurysm. When the pupil is small, the vein gradually expands at the fistula, the intima thickens, and the fibrous tissue proliferates. As the vein wall gradually thickens, an "action-like wall" is formed.

Cause

The arterial and venous traffic can be divided into direct and indirect. When the adjacent vein is injured at the same time, the wound edges directly meet each other, and direct traffic can be called within a few days, which is called direct arteriovenous fistula. For example, the wound of the arterial vein can not be directly combined, and there is a hematoma between the two. After the hematoma is mechanized, a capsule or tube is formed between the artery and the vein, which is called indirect paralysis. The proximal arteries of the tendon are progressively dilated and elongated. The arterial wall is initially thickened, degenerative changes occur later, smooth muscle fibers are atrophied, elastic fibers are reduced, the wall is thinned, and atheromatous plaques are formed. If the pupil is large, the main artery adjacent to the fistula can expand to form an aneurysm.

The distal artery is shrunk due to reduced blood flow. The vein gradually expands, the distal end can reach the last valve, and the proximal end can reach the vena cava. If the pupil is large, the pressure in the vein increases suddenly. After a few weeks of trauma, a local pulsatile mass is formed due to venous expansion, much like a pseudoaneurysm. When the pupil is small, the vein gradually expands at the fistula, the intima thickens, and the fibrous tissue proliferates. As the vein wall gradually thickens, an "action-like wall" is formed.

an examination

Related inspection

Ultrasound diagnosis of cardiovascular disease

In the history of penetrating trauma, the patient can find a pulsatile mass on his own, and there is a local snoring. One limb is swollen, varicose veins and venous valve insufficiency, local skin temperature is higher than the contralateral side, scars, murmurs and tremors in the injured area should be considered, the diagnosis of arteriovenous fistula should be considered. Patients with acute arteriovenous fistula often have severe multiple trauma or penetrating injuries at the limb. When the patient is examined, the diagnosis and treatment of arteriovenous fistula is often delayed due to the focus on the severe injury of bones and soft tissues.

Differential diagnosis

The action wall needs to be identified as follows:

The fistula between the arteries and veins is relatively simple, most of the traumatic aneurysms can be located on the arterial side, the venous side, or between the arteries and veins.

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