Combined triple sclerotherapy and rubber band ligation is an effective treatment for early hemorrhoids and incomplete mucosal prolapse, with low rates of recurrence, complications, and hemorrhoidectomy, and it can be repeated easily.

Gut wall gas cysts are uncommon and are an occasional cause of abdominal symptoms. Their aetiology is uncertain and both bacterial infection and chronic airways disease are popularly held theories. At Prince Henry Hospital (PHH) between 1980 and 1986. 8 patients with pneumatosis cystoides intestinalis (PCI) underwent 11 courses of hyperbaric oxygen treatment (HBO). This is the largest reported series of HBO treatment of PCI. In April 1990 attempts were made to recall all patients to assess cyst and symptom status. Two had died from unrelated causes; the other six were reviewed—of these, one declined further endoscopy and the other five consented. The 11 courses of treatment all resulted in pronounced symptomatic responses. This was followed by 7 early symptomatic recurrences and 4 long‐term cures. These four remain asymptomatic and cyst‐free at a minimum of 4 years to a maximum of 9 years follow‐up. Of these 4 cures, cyst resolution was documented immediately post‐HBO treatment in two and not assessed in two. In the 7 recurrences, failure of cyst resolution was documented immediately post‐HBO treatment in six and not assessed in one. Three patients had chronic airways disease, and two of these have complete resolution of PCI. It is concluded that HBO treatment is effective for PCI provided it is continued until cyst resolution has occurred and not just until symptomatic improvement. These observations suggest that KI is curable and argues against the pulmonary theory of aetiology.

Bilirubin had a higher specificity than CRP and WCC overall in patients with appendicitis. Hyperbilirubinaemia had a high PPV in patients with simple appendicitis.

Consultant leadership and specialty ownership of the process were perceived to be critical in the success of the intervention. Antibiotic stewardship programs which address social factors may have greater efficacy to optimize antimicrobial prescribing.

Largely attributed to the tyranny of distance, timely transfer of patients with major traumatic brain injuries (TBI) from rural or regional hospitals to metropolitan trauma centres is not always feasible. This has warranted emergent craniotomies to be undertaken by non‐neurosurgeons at their local hospitals with previous acceptable results reported in regional Australia. Our institution endorses this ongoing potentially life‐saving practice when necessary and emphasize the need for neurosurgical units to provide ongoing TBI education to peripheral hospitals. In this first of a two‐part narrative review, the authors describe the recommended diagnostic pathway for patients with a suspected TBI presenting to rural or regional hospitals and discuss local surgical management options in the presence or absence of a CT scanner.