title: Umbilical hernia with cholelithiasis and hiatal hernia: a clinical entity similar to Saint's triad.
abstract: We experienced two cases involving the simultaneous presence of cholelithiasis, hiatal hernia, and umbilical hernia. Both patients were female and overweight (body mass index of 25.0-29.9 kg/m(2)) and had a history of pregnancy and surgical treatment of cholelithiasis. Additionally, both patients had two of the three conditions of Saint's triad. Based on analysis of the pathogenesis of these two cases, we consider that these four diseases (Saint's triad and umbilical hernia) are associated with one another. Obesity is a common risk factor for both umbilical hernia and Saint's triad. Female sex, older age, and a history of pregnancy are common risk factors for umbilical hernia and two of the three conditions of Saint's triad. Thus, umbilical hernia may readily develop with Saint's triad. Knowledge of this coincidence is important in the clinical setting. The concomitant occurrence of Saint's triad and umbilical hernia may be another clinical "tetralogy."
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamanaka
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kumakura
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Honjo
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Hara
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Yokobori
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakai
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
keywords: Cholelithiasis; Hiatal hernia; Saint’s triad; Umbilical hernia