Triads in general surgery

Prepared by Dr Narendra Allam

DNB General Surgery
www.nextfellow.com

Triad of Coagulopathy Acidosis

Hypothermia
Physiological exhaustion
Deadly triad (lethal triad) of trauma Hypothermia,
Acidosis
Coagulopathy
Mycetoma : Pathognomic feature Painless subcutaneous mass,
Multiple sinuses
Seropurulent discharge
General anaesthesia is commonly described Unconsciousness,
as the triad of Analgesia
Muscle relaxation
Cushing’s triad (head injury) Hypertension,
Bradycardia
Irregular respiration
Normal pressure hydrocephalus Gait disturbance,
Incontinence
Cognitive decline.
Mass lesion brain (ICSOL) Focal deficits,
Seizures
Raised ICP
Menière’s disease Intermittent attacks of vertigo,
Fluctuating sensorineural hearing loss
tinnitus
Whipple’s triad (Insulinoma) Symptoms of hypoglycaemia after fasting
or exercise,
Plasma glucose levels <2.8mmol/l,
Relief of symptoms on intravenous
administration of glucose
Men 1 (Wermer syndrome) Tumour in the anterior pituitary gland,
Hyperplasia of the parathyroids
Pancreaticoduodenal endocrine tumours
Ruptured abdominal aortic aneurysm Severe abdominal and/or back pain,
Hypotension
Pulsatile abdominal mass.
GERD Retrosternal burning pain (heartburn),
Epigastric pain
Regurgitation.
Charcot’s triad (Cholangitis) Upper quadrant pain
Jaundice
Fever
Reynolds pentad Charcot triad +
Hypotension and
Mental status changes (both evidence of
shock)
Rigler’s triad (Radiological sign of Small bowel obstruction,
gallstone ileus ) Pneumobilia
An atypical mineral shadow on radiographs
of the abdomen
Reiter’s disease Urethritis or diarrhoea,
Conjunctivitis and
Polyarthritis
Enterocutaneous fistulas Sepsis,
Fluid and electrolyte imbalance,
malnutrition
Virchow triad Endothelial injury,
Venous stasis,
Hypercoagulable state.
Graves disease Signs and symptoms of thyrotoxicosis,
Goiter,
Exophthalmos
Pheochromocytoma Headache,
Diaphoresis,
Palpitations
Achalasia Dysphagia,
Regurgitation,
Weight loss
Haemobila Upper GIT hemorrhage,
Right upper quadrant pain,
Jaundice
Zollinger - Ellison syndrome Gastric acid hypersecretion, severe PUD,
and non–β-islet cell
Tumors of the pancreas
Carney triad Gastric gastrointestinal stromal tumor,
Pulmonarychondroma,
Extra-adrenal paraganglioma
Borchardt triad (Gastic Volvulus) Sudden onset of constant and severe upper
abdominal pain,
Recurrent retching with production of little
vomitus,
Inability to pass a nasogastric tube
Crohns disease Abdominal pain,
Diarrhea,
Weight loss

Portal vein,
Portal triad Hepatic artery,
And bile duct

Jaundice,
Choledochal cyst A palpable right upper quadrant mass,
abdominal pain
 Abdominal pain,
Intestinal obstruction Vomiting,
Obstipation.

Blood at the urethral meatus,

Urethral injury Inability to void,
A palpably distended bladder

Flank pain,
Renal cell carcinoma (classic <10%) Gross hematuria, and
Palpable abdominal mass

Hypotension,
Beck’s triad (Cardiac Tamponade) Muffled heart tones,
Neck vein distention.

Increased first heart sound

Auscultatory triad of mitral stenosis. Opening snap
Apical diastolic rumble.

Dilated small bowel loops (>3 cm ),

Small bowel obstruction
Air-fluid levels seen on upright films,
(X-ray abdomen)
Paucity of air in the colon

Rheumatoid arthritis,
Felty’s syndrome Splenomegaly,
Neutropenia

Extremely lax lower abdominal

Prune-belly syndrome (also known as
musculature,
Eagle-Barrett syndrome and the triad
Dilated urinary tract including the bladder,
syndrome)
Bilateral undescended testes

An elbow dislocation,
Terrible triad A radial head fracture,
Coronoid fracture

Mcl,
Unhappy triad (O'donoghue's triad) Medial meniscus,
Acl injury

Prepared by Dr Narendra Allam

DNB General Surgery
www.nextfellow.com