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Chirurgie 12. März 2015

From Ockham’s razor to Hickam’s dictum and back—Saint’s theory and the insights in herniosis

Introduction: The goal of this review article is to present the relationship between the theory of herniosis and Saint’s triad through the two philosophical stand points frequently encountered in diagnostic medicine, Ockham’s razor and Hickam’s dictum. The Saint’s triad was recognized when association between hiatal hernia, colonic diverticular disease, and gallstones have been proven to appear more often than just by pure chance alone.

Methodology: A systematic review of the literature was performed using MEDLINE (PubMed search), EMBASE, and the Cochrane databases, and it included papers published from 1948 until 2014.

Results: The data obtained by search are presented to analyze the theory of herniosis. Connective tissue disorder is being recognized as a cornerstone beneath the Saint’s triad, and the facts backing up this stand point are now systematically displayed to readers. Special emphasis is given on review of current literature reports on origin of hiatal hernia and its influence on everyday surgical perceptive.

Conclusion: Saint’s triad, once the most cited example of Hickam’s dictum is now being put to trial with the theory of herniosis, proving a sharper edge to Ockham razor stand point. It is upon the reader, from the arguments given, to choose which principle will prevail, in further thinking about this particular problem.

Prof. A.P. Simić, Assist. Prof. O.M. Skrobić, Assoc. Prof. A. Djurić-Stefanović, Assoc. Prof. D. Stojakov, Prof. P.M. Peško, European Surgery 1/2015

Volltext dieses Beitrags / entire article auf SpringerLink

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