Chirurgia; la sua teoria e pratica . ry, a volte sono circoncisi caUed, e dopo tutto i cappotti hanno dato via, consecutiva o diffusa (Fig. 92, f). Poiché il termine diffuso, tuttavia, è talvolta applicato ad un aneurisma a perdita o rotto, esso era meglio interrotto. Gli aneurismi quasi allsaccati, quando esistono da tempo, sono della varietà consecutiva, e solitamente contengono una considerevole quantità di fibrina laminata. 3. Un aneurisma dissecante è un aneurisma in cui il rivestimento interno dell'arteria e parte del rivestimento intermedio hanno dato luogo, e il sangue è stato forzato tra i due strati o

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Surgery; its theory and practice . ry, they are sometimes caUed circumscribed, and afterall the coats have given way, consecutive or diffused (Fig. 92, f).As the term diffused, however, is sometimes applied to a leakingor ruptured aneurysm, it had better be discontinued. Nearly allsacculated aneurysms, when they have existed some time, are ofthe consecutive variety, and usually contain a considerable amountof laminated fibrin. 3. A dissecting aneurysm is one in which the internal coat ofthe artery and part of the middle coat have given way, and theblood has been forced between the two layers of the middle coatfor a variable distance parallel to the course of the artery (Fig.92, e). It is most frequent in the arch and thoracic portion ofthe aorta. The blood may remain between the layers of themiddle coat, or it may escape through a rupture of the externalcoat into the tissues around, or through a rupture of the internalcoat lower down the course of the vessel into the lumen of theartery. 274 DISEASES OF SPECIAL TISSUES.. Terminations.—An aneurysm may terminate in spontaneous re-covery or in death. Spontaneous recovery may take place:—A. By the gradual de-posit of fibrin from the blood in a laminated manner on the wallsof the sac, so that the aneurysm is completely consolidated (Fig.94, a), and subsequently by condensation and shrinking becomesconverted into a small nodular mass of fibrous tissue. The arteryunder such circumstances may remain pervious, or become con-verted into a fibrous cord as far as the first collateral branchabove and below the seat of the aneurysm. Such a favorabletermination may be brought about by the retardation of the blood current induced by—(i) theFig. 94- lowering of the hearts ac- tion ; (2) the pressure of theaneurysm on the artery aboveits opening into the sac (Fig.94, c) ; (3) the/ar/Zci/block-ing of the mouth of the sacwith a piece of detachedcoagulum; (4) the impac-tion of a piece of clot in theartery below the mouth ot thesac

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• bookcentury1800
• bookdecade1890
• booksubjectsurgery
• bookyear1896