Background: Ten Vietnamese boat people with septicaemic shock or pneumoperitoneum were admitted between April and July 1993.Methods: In order to investigate the cause of unexplained septicaemic shock and spontaneous pneumoperitoneum in Vietnamese boat people, an audit was carried out. Attention was paid to the mode of presentation, abnormal physical signs, presence of injection marks, radiological signs, subsequent progress and outcome.Results: The clinical and radiological findings were all in favour of self‐inflicted conditions. A retrospective review from the hospital record revealed that the emergency admission rate and disappearance rate of the Vietnamese boat people was higher than those of other patients (P<0.001).Conclusion: It is concluded that self‐inflicted conditions are a serious problem among the Vietnamese boat people, who may use hospital admission to avoid the detention cen