Patrick Collins

Patrick Gerard Collins (1923 – 1999) was an Irish general surgeon.

Surgical interests in the biliary tract, liver and pancreas. He made contributions to surgical literature in the area of biliary surgery, particularly biliary reconstruction.

Patrick ‘Paddy’ Collins contributed significantly to the surgical education of both undergraduate and postgraduate surgical students and was appointed as Professor of Surgery within the Royal College of Surgeons in Ireland.

Collins described the characteristic tendency of patients experiencing gallstone pain to reach behind their back and point upwards towards the tip of the right scapula with their thumb (Collins sign).

  • Born 17 October 1923, Cork, Ireland
  • 1947 – MB BCh National University of Ireland
  • 1951 – FRCS
  • 1953 – Surgeon at the Lahey Clinic ,Boston
  • 1959 – Consultant surgeon at Jervis Street Hospital, Dublin. Established a tertiary referral unit for repair of bile duct injuries
  • 1968 – FACS
  • 1970 – FRCSI
  • 1978 – President of the Pancreatic Society of Great Britain and Ireland
  • President of the Royal Academy of Medicine in Ireland
  • Died 15 April 1999

Medical Eponyms
Collins sign (2009)

In cases of cholelithiasis; unprompted demonstration of the radiation of pain to the tip of scapula by placing the hand behind the back with an upward reaching thumb.

Pain of cholelithiasis is often referred to the lower angle of the scapula. Prof Patrick “Paddy” Collins taught that patients experiencing such pain radiation often demonstrated the origin of the referred pain by placing one hand behind their back with the thumb pointing upwards. This became known amongst his students as Collins’ sign.

Collins’ sign demonstrated to Professor Collins
Prof Paddy Collins demonstrating Collins’ sign

Statistical evaluation by Gilani et al (2009)

Case-control study performed on 202 patients with symptomatic cholelithiasis and 200 control patients (with oesophagitis, gastritis or duodenal ulcer). Collins’ sign was positive in 104 patients (51.5%) with symptomatic cholelithiasis who demonstrated the ‘thumb up’ orientation of pain referred to the tip of scapula; compared to 7.5% in the control group.

Major Publications


BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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