Spontaneous lung herniation is a rare pathological entity. We present a case of intercostal type of spontaneous lung hernia after heavy lifting complicated with huge soft tissue hematoma, single rib fracture, hemothorax, diaphragmatic laceration, and great omentum pleural cavity herniation in a 46-year-old man. His comorbidities were arterial hypertension, congestive heart failure, and type II diabetes mellitus and had no history of trauma, surgical procedures in his thoracic wall, or chronic obstructive pulmonary disease. Physical examination revealed a huge left-sided flank hematoma. Chest X-ray determined stable intercostal lung hernia confirmed by chest computed tomography. Conventional approach by left mid-lateral thoracotomy was used for surgical repair of the lung hernia and stabilization of the intercostal space. The patient was discharged on the 9th postoperative day in a good condition. Control examination 2 years after the operation found no deformation of the thorax or recurrence of the lung hernia. This is a case of interest of spontaneous intercostal lung hernia because of the number and type of associated injuries. This case demonstrates low morbidity and good postoperative result by conventional surgery in intercostal lung hernias.

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The aim of this study is to analyze the morbidity and mortality in patients with rib fractures in blunt chest trauma. The group of 212 patients with rib fractures was examined. Fractured ribs and associated thoracic injuries were established by imagine methods (plain chest radiographs and computed tomography) and pathological examination. Fractures of one or two ribs were established in 72 (33, 96 %) patients. Multiple rib fractures (≥ 3 ribs) were established in 140 patients. Lung contusion was the most common associated thoracic injury. Mortality, as an outcome of thoracic trauma, was established in 36 (16, 98 %) of patients. The level of mortality was higher in the group of patients, age > 65 years. Lung contusion was main cause of death in patients with fractured ribs. Conclusion. This study has proven that the age over 65 years, bilateral rib fractures and lung contusion are three risk factors for mortality in patients with blunt thoracic trauma.

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.