| Suspensory muscle of duodenum | |
|---|---|
| Duodenojejunal fossa. (Suspensory muscle of the duodenum not labeled, but region is visible.) | |
| Latin | musculus suspensorius duodeni |
The Suspensory muscle of duodenum or Ligament of Treitz (named after Václav Treitz) connects the duodenum of the small intestines to the diaphragm. It contains a slender band of skeletal muscle from the diaphragm and a fibromuscular band of smooth muscle from the horizontal and ascending parts of the duodenum. When it contracts, the suspensory muscle of the duodenum widens the angle of the duodenojejunal flexure, allowing movement of the intestinal contents.[1]
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It arises from the right crus as it passes around the esophagus, continues as connective tissue around the stems of the celiac trunk and superior mesenteric artery and inserts into the third and fourth portions of the duodenum and frequently into the duodenojejunal (DJ) flexure (between the duodenum and the jejunum) as well.
This ligament is an important anatomical landmark of the duodenojejunal junction.
This is actually a thin muscle that wraps around the small intestine where the duodenum and jejunum meet. It passes behind the pancreas and is attached above to the spine and the diaphragm.
It is an especially important landmark to note when looking at the bowel for the presence of malrotation of the gut, a syndrome often suspected in young children when they have episodes of recurrent vomiting. Visualizing a normal location of the ligament of Treitz in radiological images is critical in ruling out malrotation of the gut in a child; it is abnormally located when malrotation is present. An abnormally low and fixed position of the ligament of Treitz is a known cause of superior mesenteric artery syndrome. However, identifying it on a CT scan is difficult.[2]
Hematemesis (blood in the vomit) or melena (black tarry stools) usually indicate a gastrointestinal bleed from a location proximal to the ligament. Hematochezia (bright red blood or clots in the stools) usually indicates a gastrointestinal bleed from a location distal to the ligament.
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