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Case Variation of Saint`s Triad

Gabriela Kirisheva, Anton Tonev, Alexander Zlatarov, Nikola Kolev, Valentin Ignatov, Georgi Ivanov


Introduction: The classic Saint`s triad  involves hiatal hernia, gall stones and diverticulosis of the colon. This condition was described for the first time by Professor C. F. M. Saint from the University of Cape Town  a quarter of a century ago. There might be some variations of this kind of pathology.  

Materials and Methods: In this paper we describe three cases of different variations of Saint`s triad. The first patient was with hiatal hernia, cholelithiasis and umbilical hernia, the second one was with the same combination of diseases and the third one was with gall stones and diverticulosis of the colon. All three patients were female and overweight ( body mass index of 25.0-29.9 kg/m2) with a history of pregnancy and surgical treatment of cholelithiasis. Additionally, the three patients  had two of the three  conditions of Saint`s triad.

Results and conclusion: Based on the analysis  of the pathogenesis of these three cases, we considered that these four diseases (Saint`s triad and umbilical hernia)   are  associated with  one another. Obesity is a risk factor  for umbilical hernia  also for Saint`s triad. History of pregnancy , female sex and older age  might also be connected  to umbilical hernia and Saint`s triad. Knowing the variations of this condition  is very important  for the general surgeon. It shows us, that three completely different pathologies might be related. The possible pathogeneses are   the systematic  connective  tissue diseases, which are  caused by  an impaired activity of MMP-2 . We have to know that if we  find one of them  in a patient, we also have to look for the other components of Saint›s triad.


Saint`s triad, umbilical hernia, gall stones, hiatal hernia



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