Suspensory muscle of the duodenum
Overview
The suspensory muscle of the duodenum is the proper name of what is commonly known as the ligament of Treitz (named for Václav Treitz), and it refers to tissue that connects the duodenum of the small intestines to the diaphragm. It is also known as the suspensory ligament of the duodenum.
Structure
It arises from the 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. Composed of a slip of skeletal muscle from the right crus of the diaphragm and a fibromuscular band of smooth muscle from the third and fourth parts of the duodenum, when it contracts, it has the effect of opening the DJ flexure and permitting the flow of chyme.
While commonly referred to as a ligament, it is officially both a suspensory muscle and a suspensory ligament due to its composition and function.
Clinical significance
This muscle/ligament is an important anatomical landmark of the duodenojejunal junction, used to divide the GI tract into an upper portion and a lower portion.
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.