Suspensory Muscle of Duodenum - Clinical Significance

Clinical Significance

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.

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 bleeding from a location distal to the ligament.