Ligament of Treitz
It is often used interchangeably with duodenojejunal (DJ) flexure.
The ligament of Treitz comprises two parts, the first of which passes from the right crus of the diaphragm to connective tissue surrounding the celiac artery. The second, muscular, part descends from said connective tissue to the duodenum, between the pancreas and the left renal vein. It is the second part that actually suspends the duodenojejunal flexure. 1
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.
In adults, the ligament often involutes or is entirely absent. Hence, it is virtually impossible to image 1,2. 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".
- 1. Kim SK, Cho CD, Wojtowycz AR. The ligament of Treitz (the suspensory ligament of the duodenum): anatomic and radiographic correlation. Abdominal imaging. 33 (4): 395-7. doi:10.1007/s00261-007-9284-3 - Pubmed
- 2. Meyers MA. Treitz redux: the ligament of Treitz revisited. Abdominal imaging. 20 (5): 421-4. Pubmed
- 3. Susan Standring. Gray's Anatomy: The Anatomical Basis of Clinical Practice, 41st edition. Elsevier, 2016. ISBN: 9780702052309