THE DEVELOPMENT of an abnormal arterial-venous communication following injury to an adjacent artery and vein is a well-recognized sequela of operative surgery. This complication has been described following a variety of procedures. These include the en-masse ligature of the superior thyroid artery and vein during thyroidectomy,1 of the uterine artery and vein during hysterectomy,2 of the renal artery and vein during nephrectomy,3 of the geniculate artery and vein during arthrotomy, and of the femoral artery and vein during amputation.4 In addition, the development of a fistula can occur following inadvertent penetration by a surgical instrument of the right common iliac artery and inferior vena cava during intervertebral disc removal,5 by a fixation device through the facial artery and vein during the application of an Anderson splint,6 by the insertion of a Steinmann pin through the anterior tibial artery and vein during fracture fixation,7