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Background: The aim of this report is to present a case of a blunt abdominal trauma with vascular and spinal involvements of an overweight man, caused by the front seat safety belt. Case presentation: It took place as a result of the car bonnet collision with a roadside pillar. During the primary inspection of the crash site, it was found that the car had collided with a roadside pillar. The driver was found dead in the driver's seat with the seat belt on. The lower part of the belt was in the inguinal region and the upper part was high on the chest, separated by the bulky midriff. The autopsy revealed a transverse fracture of the body of tenth thoracic vertebra, complicated by a torn abdominal aorta, and severe bleeding into the abdominal cavity, which was the cause of the death. The complications of the abdominal trauma result from the atypical position of the seat belt holding the upper and lower part of the body to the seat at two very distant levels, while between them the bulky, heavy midriff continued to move forward, carrying with it the vertebral column and surrounding anatomical structures. On the other hand, the forceful contact between the abdominal wall and the instrumental panel of the car generates pressure which transmits force through the adjacent organs to the aortic wall. The specific anthropometric features of the victim had an impact on the mechanism of death. The improper position of the seat belt relative to the body affected the severity of abdominal injuries, instead of protecting from them. Conclusions: The driver's body disproportion, combined with the restraining effect of the seat belt, could increase the risk of a fatal outcome. It is incorrect to think that if the victim had not worn a seat belt, he would have survived. The safest seatbelt type for occupants with a similar anthropometric data would be the 4-point seat belt system, which is used in children's car seats. This type of safety belt is crossed over the chest and abdomen and holds the entire trunk better at dynamic loads in all directions.

PURPOSE. The facial artery is one of the main arteries which supply the face with blood. The different types have been researched not only for anatomical purposes but also to facilitate the different medical specialties. METHODS AND RESULTS. Our team found an unusual case of a facial artery with smaller lumen. The region, which it supplies, is partially substituted by the transverse facial artery. In the observed course the facial artery had a considerably smaller caliber than usual. After it appears on the surface of the face it divides into two untypical branches - anterior and superior. Contrariwise the transverse facial artery has a significantly bigger lumen. The separate branches, which usually originate from the facial artery, here arise from the aforementioned artery. CONCLUSIONS. These types of anatomical variations are very important for muscle and skin flaps in plastic surgery of the face. Every deviation from the normal anatomy of the main blood vessels can also lead to errors in invasive surgery procedures and medical imaging. The vascularization of the face and its variations is subject for many different disciplines.

The purpose of the study was to present a rare case of post-traumatic Parinaud’s syndrome with a history of closed head injury. The clinical characteristics, examination, and management are presented in a 12-year-old boy who was a victim of physical violence at the hands of a young boy who punched him in his chin with his fists, with associated paralysis of the upward gaze of the left eyeball, and convergence nystagmus with pupillary involvement. CT examination indicated posttraumatic lesions in the dorsal midbrain and in the cavity of third ventricle, suggestive of acute hemorrhages. Posttraumatic Parinaud’s syndrome is a rare phenomenon that can occur in a case of closed head trauma as contrecoup injury.

Child abuse syndrome is a medico-social problem widely spread around the world, which includes a complex of clinically manifested forms of violence against children. This syndrome includes different forms of physical violence, sexual violence, neglect, and emotional violence against children. The main problem with this type of violence continues to be the large number of unregistered “hidden” cases. The consequences of violence against children are serious and have a lasting negative effect on the physical and mental health of the victims. Child abuse is often a result of impulsive violent behavior with minimal provocation and may have a fatal outcome. We present a case of a 3-year-old boy, admitted to the Emergency Department of the Municipal Hospital in Asenovgrad, Bulgaria, in a state of biological death. Case circumstances during the police investigation were unclear and the body was transported for forensic examination. During the forensic autopsy, many traumatic injuries were observed over the whole body – bruises of different ages, fractures of bones, abdominal trauma with bucket-handle tear of the mesentery, thoracic trauma with contusions and ruptures of the lungs, rupture of the diaphragm, and many other injuries that are specific predictors for this type of child physical abuse. The main aim of the present report is to enrich the knowledge of medical workers in their routine practical work in the identification and determination of child abuse syndrome. It could prevent the fatal outcome and reduce the mortality from this specific type of violence.