Saint's triad

Last revised by Dr Daniel J Bell on 23 Jun 2022

Saint's triad is the concurrence of hiatus hernia, cholelithiasis and colonic diverticulosis. It was named after the British-South African general surgeon, Charles Frederick Morris Saint (1886–1973) 2. Although it was first published in 1948 by C J B Muller, later Head of the Department of Radiology at the University of Stellenbosch in the Western Cape, South Africa 4

There is no underlying pathophysiology that might explain the synchronous presence of these three conditions, which is the point Professor Saint was making.

Saint's triad was introduced by him as a counterweight to Occam's razor; that is, a patient's presentation must not always be assumed to be the result of a single underlying disease process but maybe due to two or more concurrent unrelated pathologies. This has become of increasing importance in wealthier nations as lifespans have increased and patients with multiple comorbidities have become increasingly common.

This important concept has also been expressed in a different form as Hickam's dictum, namely "A patient can have as many diagnoses as he damn well pleases".

See also

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