What is the function of the ligament of Treitz (suspensory muscle of the duodenum)?

From the Guidelines

The ligament of Treitz, also known as the suspensory ligament of the duodenum, plays a crucial role in suspending and anchoring the duodenojejunal flexure in place, marking the transition from the duodenum to the jejunum in the small intestine. The primary function of the ligament of Treitz is to maintain the proper anatomical position of the duodenum and prevent excessive mobility of this portion of the small intestine. This ligament is clinically significant as it serves as an important anatomical landmark during abdominal surgeries and radiological examinations, defining the boundary between the upper and lower gastrointestinal tract. The ligament of Treitz is essential for diagnosing various gastrointestinal disorders and planning surgical interventions in the upper abdomen, as noted in the evaluation of malrotation using fluoroscopy Upper GI Series 1. Key points about the ligament of Treitz include:

• It connects the junction between the duodenum and jejunum to the diaphragm
• It helps maintain the proper anatomical position of the duodenum
• It prevents excessive mobility of the duodenum
• It serves as an important anatomical landmark during abdominal surgeries and radiological examinations
• It plays a role in certain pathological conditions, such as superior mesenteric artery syndrome The evidence from the study by Sizemore et al 1 highlights the importance of meticulous technique in interpreting UGI series to avoid false-positive and false-negative interpretations. In real-life clinical practice, understanding the location and function of the ligament of Treitz is vital for making accurate diagnoses and planning effective treatments for gastrointestinal disorders. The ligament of Treitz is a critical anatomical structure that requires careful consideration in various clinical scenarios, including abdominal surgeries and radiological examinations 1.

From the Research

Function of the Ligament of Treitz

The ligament of Treitz, also known as the suspensory muscle of the duodenum, plays a crucial role in the abdominal anatomy. Its functions can be summarized as follows:

• It suspends the distal duodenum, providing support and maintaining its position 2, 3.
• It acts as a valve, regulating the duodenal content emptying 4.
• It is involved in the motor evacuatory function of the duodenum, with its transection affecting the duodenal emptying process 4.

Anatomical Variations

The ligament of Treitz exhibits anatomical variations, including:

• Differences in the amount of striated muscle tissue, with more tissue present in normoduodenum and dolichoduodenum variants 5.
• Variations in the topographic anatomy, with different attachments and diversions from the duodenojejunal flexure 4.
• Presence of loose fibrous connective tissue with single smooth muscle fibers in duodenoptosis variants 5.

Clinical Significance

The ligament of Treitz has clinical significance, particularly in:

• Duodenal stasis, where dissection of the ligament can eliminate anatomical prerequisites for duodenostasis 5.
• Duodenal displacement by extrinsic masses, where the ligament's weakness and variability in size and shape may not prevent displacement 3.