Background: Vascular trauma is a complex and evolving area. Unlike internationally, the epidemiology of vascular trauma is not well documented in Australia; the most recent study was published in 2013. Gold Coast University Hospital (GCUH) is a level 1 trauma centre in Queensland, Australia. The aim of this study was to describe the epidemiology and outcomes of vascular trauma at a level 1 trauma centre, and compare these with the Australian and international literature. Methods: All individuals who presented to GCUH between January 2014 and December 2019 with vascular injury were retrieved from the GCUH prospective trauma database. A descriptive analysis was undertaken on this cohort. Results: The incidence of vascular trauma as a percentage of total trauma remained stable over the study period. The study included 5454 trauma admissions to GCUH, of which 213 sustained vascular injuries. Males were more likely to be injured and blunt trauma was more common than penetrating. Blunt trauma was associated with increased injury complexity. The mortality rate was 8.5% and 10 patients required amputation. Conclusions: The proportion of vascular injuries as a percentage of total trauma in Australia is higher than in previous studies. Vascular trauma causes significant injuries and has a higher mortality rate than general trauma.

Background: Abdominal and pelvic vascular injuries are amongst the most lethal injuries sustained by trauma patients. Unlike internationally, the epidemiology is not well documented in Australia. Gold Coast University Hospital (GCUH) is a level one trauma centre in Queensland, Australia. This study aims to identify the epidemiological patterns of abdominal and pelvic vascular traumatic injuries, their interventions and outcomes, and compare these with national and international data.  Methods: All individuals who presented to GCUH between January 2014 and December 2019 with abdominal or pelvic vascular injuries were retrieved from the GCUH prospective trauma database. A descriptive analysis was undertaken on this cohort. Results: The study reviewed 5452 trauma admissions to GCUH, of which 68 patients sustained abdominal or pelvic vascular injuries. The number of blunt and penetrating trauma cases were 53 (77.9%) and 15 (22.1%) respectively, and 51 (75%) of the patients were male. Interventions were required in 57 patients (83.8%). Of these interventions, 28 were open (41.2%), 27 were endovascular (39.7%) and 2 required both open and endovascular interventions (2.9%). The most commonly injured vessels were the visceral arteries (51.9%) and iliac arteries (22.7%). The mortality rate was 8.8% which were all as a result of blunt trauma.  Conclusions: Abdominal and pelvic vascular trauma causes significant injuries with a higher mortality than general trauma. Given the majority of cases occurred secondary to road accidents, motor vehicle safety interventions and prevention programmes are likely to have the greatest effect on reducing the abdominal and pelvic vascular injury rate in Australia.

Ganglioneuromas (GN) are rare, benign tumours of the autonomic nervous system which are seldom encountered in the gastrointestinal tract. They may occur as solitary lesions or more commonly as multiple lesions, also known as ganglioneuromatosis. Endoscopically they have no identifiable phenotypic characteristics and therefore diagnosis can only be confirmed through histological analysis. Microscopically they are composed of ganglion cells, nerve fibres and Schwann cells and show S-100 protein immunoreactivity. Clinically, there are no specific symptoms eluding towards the diagnosis of solitary ganglioneuromas of the gastrointestinal tract with most patients remaining asymptomatic. Due to their rarity, no guidelines current exists for solitary colonic GNs, however consensus exists that endoscopic resection is curative with no evidence of recurrence following total excision. This case gives an account of a solitary colonic ganglioneuroma in the sigmoid colon encountered during a screening colonoscopy in a 47-year-old male.

Background: Vascular trauma remains a complex area for clinicians and its management is constantly evolving. The increasing use of endovascular modalities and non-operative management has led to significant changes in the treatment of vascular trauma. The aim of this study was to identify the current management and outcomes of vascular trauma at a Level 1 trauma centre in Queensland, Australia and compare this with the current literature.Methods: All individuals who presented to GCUH with vascular injuries between January 2014 and December 2019 were identified from the GCUH trauma database. A descriptive analysis was performed on this cohort.Results: 213 patients were identified in our cohort; 51 were managed non-operatively, 121 were managed with open surgery, 37 were managed endovascularly and 4 had a combination of open and endovascular intervention.Conclusions: The proportion of vascular injuries managed with endovascular interventions or non-operatively has increased within the study period. This study shows that the trends of management for vascular trauma in Australia are consistent with recent international literature.

Granular cell tumours (GCTs) are a rare type of soft tissue tumour that can be found in many anatomical locations however its occurrence in the perianal region is exceedingly rare. GCT typically presents as a firm painless mass, and therefore, it may be mistaken for other more common anorectal pathology. Most are benign, however 1-2% of GCTs are malignant. Complete surgical excision is recommended for accurate diagnosis and adequate treatment. This case reports a 75-year-old female who was found to have a perianal GCT.