This study is unique in that it strives to unfold, perhaps for the first time, the problem of stab injuries and resultant significant mortality and morbidity within the Aboriginal population of Central Australia. Demographic features presented in the study are quite different from other published Australasian and overseas experiences. There were 1550 stab injury admissions to Alice Springs Hospital during a 7-year period (July 1998 to June 2005). Thirty-two patients were dead before arrival, and there were only three deaths in the hospital during the period of study. The most unique demographic feature was that 99.99% were Aborigines, 53% were women and the most common location of injury was in town camps and homes. The mean age of this population was 31 years, and the average length of stay in hospital was 3 days. The most common site of the stab injuries was the thigh with a total of 605 (38%). Stab injuries to the abdomen were significantly low with 68 (<1%). Twenty-one per cent (332) presented 24 h to 10 days after stabbing. Another 21% (335) absconded before the completion of treatment. Of the victims, 31% (481) were under the influence of alcohol. Twenty per cent (311) of the patients presented with repeat stabbings during the study period. Traditional punishment is still practised in Central Australia and thus explains the high number of thigh injuries. A particular pattern of traditional stab injuries was also noted; medial thigh to kill, posterior thigh to permanently disable and lateral thigh to punish. Rampant alcoholism and social and family breakdown are thought to be significant contributors to the high incidence of violence in Alice Springs. There were only five firearm traumas during this period, two were self-inflicted and three were accidental.

A case of Peutz-Jeghers Syndrome (PJS) presenting in infancy with gastric-outlet obstruction is described. PJS may become symptomatic at any age and should be suspected when there are obstructive symptoms or gastrointestinal blood loss in a baby with a positive family history. Contrast studies and endoscopy are useful in diagnosis and surveillance. Treatment requires a combination of endoscopy and laparotomy/laparoscopy. Because of the reported cancer risk, we recommend surveillance from the age of diagnosis.

Amyand’s hernia is a rare type of hernia where the appendix is found within the hernial sac. We present a case of appendicitis within an Amyand’s hernia in a 72-year-old man who presented with a acutely painful, irreducible right inguinal lump. He underwent open appendicectomy and primary tissue repair with subsequent delayed elective mesh hernioplasty 3 months later.

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The single vehicle rollover accident is a highly complex crash mode and there is growing concerns about its incidents and consequences in central Australia. The aim of this paper is to assess: 1 The incidence and injury patterns of rollover accidents 2 Pre rollover characteristics on rollover propensity 3 The injury severity and outcome of rollover accidents The absence of speed limit, unfenced roads, vast distances traveled, unsealed roads and high use of alcohol makes the spectrum of MVA' s in NT unique.In this two year period of study from Jan 2004 -Dec 2005, there were 470 motor vehicle accidents of which 126 were single vehicle rollover accidents. 132 patients were admitted; 73 NT residents of which 45 were of aboriginal origin and 14 were international tourists. There were 37 deaths in Central Australian roads and 20 were due to single vehicle rollover accidents. None of the deaths occurred at the Alice Springs hospital . Most rollover accidents occur at a speed above 100 km/h. 24 patients had an ISS > 15 and 35% of all injuries were to head, neck and shoulder. Rollovers occurred when the vehicle left the road way and encountered a tripping mechanism such as soft dirt or loose gravel. Those who were belted fared better than those unbelted occupants. Completely ejected occupants were all unbelted. Mean time to hospital from time of accident was 8Hrs. Primary prevention strategies need to involve remote communities, tourists traveling in central Australia and address alcohol and restraint use.