The ligament of Treitz, also known as the suspensory ligament of the duodenum, is a double fold of peritoneum suspending the duodenojejunal flexure from the retroperitoneum.
It is often used interchangeably with duodenojejunal flexure.
On this page:
Anatomy
The ligament of Treitz comprises two parts:
- accessory muscle, also known as Hilfsmuskel 1
- passes from the right crus of the diaphragm to connective tissue surrounding the coeliac artery
- composed of skeletal muscle tissue
- suspensory muscle of the duodenum
- descends from connective tissue of coeliac artery to the duodenojejunal flexure, between the pancreas and the left renal vein
- this is the part that suspends the duodenojejunal flexure
- composed of smooth muscle
Pathology
The ligament of Treitz is a landmark:
- for the radiological diagnosis of intestinal malrotation and partial rotation
- for discriminating between upper and lower gastrointestinal bleeding
Congenital superior mesenteric artery syndrome can be caused by a short ligament of Treitz.
Radiographic features
In adults, the ligament often involutes or is entirely absent. Hence, it is virtually impossible to image 2,3. Its location can be inferred from its anatomical relations (see duodenojejunal flexure).
History and etymology
It is named after Czech pathologist Václav Treitz, who described it in 1853, referring to it as the "suspensory muscle of the duodenum".
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