Munchausen Syndrome (MS) has been widely recognized as a severe manifestation of factitious disorder, a condition where individuals intentionally fabricate or exaggerate symptoms for psychological gratification. It represents a complex diagnostic challenge due to its elusive nature and intricate relationship with various medical conditions. We present a clinical case of a 44-year-old woman observed in the context of Liaison Psychiatry, demonstrating the intricate interplay between chronic medical conditions, psychiatric factors, and the challenges in diagnosing and managing MS. The patient exhibited a history of recurrent hospitalizations, difficult-to-heal injuries, and a pronounced preference for surgical interventions. Despite diagnostic difficulties and poor therapeutic adherence, a multidisciplinary team approach involving plastic surgery, orthopedics, physical medicine, and rehabilitation, alongside Liaison Psychiatry, led to the diagnosis of MS with chronic osteomyelitis, ultimately necessitating a transtibial amputation. The case underscores the importance of early detection, a multidisciplinary approach, and the role of Liaison Psychiatry in managing MS. While early diagnosis may not alter the disease course, it can prevent unnecessary interventions and mitigate associated risks. The case also highlights the need for continuous psychiatric support and family involvement in addressing the recurrence of self-injurious behaviors. Further research is essential to enhance our understanding and develop effective treatment strategies for MS, contributing to improved diagnostic precision and overall management of this challenging psychiatric disorder.

The no-fault principle is one of the pillars of workers\' compensation schemes operating in the States, Territories and the Commonwealth in Australia. This article examines the strength of this principle having regard to provisions common to all jurisdictions which disentitle workers where there is evidence of serious and wilful misconduct or self-inflicted injury. It examines the legislative framework of these provisions in detail noting some differences in approach and effect. The article also traces the origins of these provisions and how they have been applied since enacted. We conclude that the no-fault principle remains robust and intact in Australian workers\' compensation schemes.

Self-inflicted abdominal stab wounds are generally uncommon and there is no published report of survivors after extensive self inflicted disembowelment with mutilation. Here we present a case of 28 year old male who was brought to hospital 2 1/2 h after disembowelment through self inflicted abdominal stab injuries. The patient had hypovolemic shock due to bleeding from the mesentery and a 450 cm segment of small bowel which had been pulled out from 2 abdominal stab wounds and slashed multiple times by him. He had alcohol intoxication and hallucinations and did not seem to be in pain or emotionally affected by the severe injury. After resuscitation, and emergency resection with anastomosis he had an uneventful post-operative recovery. On psychiatric evaluation during follow-up, he was found to have schizophrenia aggravated by alcohol abuse and was treated accordingly. As self mutilation can be the first presentation of a psychotic episode, a psychiatric evaluation is necessary for all patients with self inflicted injuries.