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ARTERIOVENOUS aneurvsm is well known as a result larger vessels could have occurred after a straightforward of trauma, but aneirysrn between the superior thyroidectomy. thyroid artery and vein following ligature of the Radiological visualization of the aneurysm was carried superior thyroid pedicle appears to be very unusual. out (J. A. R.). After aneurysm. In order to overcome this difficulty it was decided to use a serial film changer, such as is used in aortography and angiocardiography. Ten C.C. of 50 per cent diaginol were injected rapidly while four films were exposed. It was then clear that the films taken early during injection were the most valuable and the injection was therefore repeated for exposure of a single lateral film at an early phase of injection. The arteriograms clearly show the superior thyroid artery entering the aneurysm, which is drained by a large vein into the inFerna1 jugular vein (Figs. 533, 534). Exploration of the neck was carried out (J. B. 0.) on April 9 through a transverse incision. The sternomastoid was divided, exposing grossly enlarged common facial and internal jugular veins (Fig. 535). It was at first thought that the common facial vein was discharging arterial blood into the internal jugular vein, but further dissection revealed an aneurysm between the superior thyroid artery and vein in the region of the remnant of the left lobe of the thyroid gland (Fig. 536). The artery was ligated close to its origin and the aneurysmal sac was removed with ligature of the superior thyroid vein and common facial vein. The wound was closed around a rubber drain.The patient's symptoms were immediately relieved, and he was perfectly well when last seen in July, 1958. Acknowledgement.-We wish to thank Mr. Lee of the Photographic Department, University of Liverpool, who kindly provided the photographs which were taken during the operation. S O L I T A R Y N O N -P A R A S I T I C C Y S T S O F T H E L I V E R

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