The duodenojejunal flexure is the sharp bend where the retroperitoneal duodenum turns forward to become the mobile jejunum. It lies to the left of the L2 vertebra, just below the body of the pancreas. It is suspended from the right crus of the diaphragm by the suspensory muscle (ligament) of the duodenum.
| Location | Left of the L2 vertebral body, inferior to the body of the pancreas and behind the transverse mesocolon |
|---|---|
| Parts |
|
| Nerve Supply | Superior mesenteric plexus; Vagus nerve |
| Blood Supply | Inferior pancreaticoduodenal arteries; First jejunal artery |
| Venous drainage |
|
| Lymphatic drainage |
|
Marks the transition from the fixed duodenum to the mobile jejunum and helps hold the duodenal loop in position.
This landmark divides upper from lower gastrointestinal bleeding and is used by surgeons to start running the small bowel. On an upper GI contrast study in a vomiting baby, a flexure lying right of the midline or too low indicates malrotation, which risks midgut volvulus.
Twisting of the small bowel around its narrow mesenteric base in malrotation, causing bilious vomiting and bowel ischaemia in infants; a surgical emergency.
Herniation of small bowel into the fossa near the flexure, the most common congenital internal hernia.
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