Suspensory Ligament of the Duodenum Detail

musculus (ligamentum) suspensorius duodeni (Treitz) detail

The suspensory ligament of the duodenum (ligament of Treitz) is a fibromuscular band connecting the right crus of the diaphragm and the celiac artery to the duodenojejunal flexure, suspending the junction from the posterior abdominal wall.

Region: Abdomen

Biomechanics

Function & Actions

Supports the duodenojejunal flexure in the left upper abdomen, provides the critical reference point for the start of the jejunum in surgical anatomy, and anchors the duodenojejunal angle during intestinal rotation.

Clinical Relevance

Clinical Notes

The ligament of Treitz is the primary landmark in gastrointestinal surgery — it defines the boundary between upper (duodenum, jejunum proximal) and lower GI bleeds, and marks the start of the jejunum in Roux-en-Y reconstruction, small bowel resection, and bowel measurement. Duodenal obstruction from the superior mesenteric artery (SMA syndrome) occurs at the duodenojejunal flexure.

Pathology

Common Injuries & Conditions

Ligament of Treitz as GI Bleed Landmark

Bleeding proximal to the ligament of Treitz is defined as upper GI haemorrhage; distal is lower GI — the critical anatomical boundary for GI bleeding classification and endoscopic versus interventional management.

SMA Syndrome at Duodenojejunal Flexure

Superior mesenteric artery compression of the third part of the duodenum near the ligament of Treitz producing intermittent duodenal obstruction in thin patients, managed by positional eating or surgical duodenojejunostomy bypass.