Ligament of Treitz

Last revised by Dr Rohit Sharma on 26 Oct 2020

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.

The ligament of Treitz comprises two parts: 

  1. accessory muscle, also known as Hilfsmuskel 1
    • passes from the right crus of the diaphragm to connective tissue surrounding the celiac artery 
    • composed of skeletal muscle tissue
  2. suspensory muscle of the duodenum
    • descends from connective tissue of celiac 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

The ligament of Treitz is a landmark:

Congenital superior mesenteric artery syndrome can be caused by a short ligament of Treitz.

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).

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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