Saint’s Triad is the association of hiatal hernia, gallbladder disease, and diverticulosis in patients with atypical abdominal symptoms.
Termed by British surgeon Professor Charles Frederick Morris Saint who emphasized:
…the importance of considering the possibility of multiple separate diseases in a patient whenever his or her history and the results of the physical examination were atypical of any single condition.
Saint created this concept to caution medical students against misuse of Occam’s Razor ‘the simplest solution is usually the correct one’. Hilliard A. N Engl J Med. 2004.
The principle underlying Saint’s triad is also expressed as Hickam’s Dictum which asserts that at no stage should a particular diagnosis be excluded solely because it doesn’t appear to fit the principle of Occam’s razor.
Systematic research of 684 patients subjected to radiological examinations found 7 cases of Saint’s triad (1.02%) and 86 cases of bifocal associations; 59 cholelithiasis with diverticulosis, 17 cholelithiasis with hiatus hernia; 10 diverticulosis with hernia. Scaggion G.Minerva Med. 1987.
- Saint CFM. Saint’s triad.The origin and story of its recognition. Rev Surg. 1966; 23: 1-4. [PMID 5905034]
- Burkitt DP, Walker AR. Saint’s triad: confirmation and explanation. S Afr Med J. 1976 Dec 18;50(54):2136-8.
- Whitworth, Judith A.; Firkin, Barry G. Dictionary of medical eponyms (2nd ed.). New York: Parthenon Pub.1996 p. 354. [ISBN 1-85070-477-5]
- Hilliard A. A., Weinberger S. E., Tierney L. M. Jr., Midthun D. E., and Saint S. Occam’s Razor versus Saint’s Triad. N Engl J Med 2004;350:599-603 [PMID 14762188]
- Scaggion G, Poletti G, Riggio S. Saint’s triad. Statistico-epidemiologic research and case contribution. Minerva Med. 1987. [15;78(15):1183-7]