The ligament of Treitz (the suspensory ligament of the Duodenum): anatomic and radiographic correlation

Seuk Ky Kim, C. D. Cho, Andrij R. Wojtowycz

The ligament of Treitz suspends the distal duodenum but it has not been identified on abdominal CT scans. Duodenal displacement by an extrinsic mass is not an uncommon finding and is not prevented by the ligament of Treitz. The purpose of this study was to evaluate the size and strength of the ligament of Treitz in autopsy cases and then its visibility on abdominal CT scans. The ligament of Treitz was examined in 18 autopsy cases. The ligament was studied in situ and dissected for macro and micro examination. Size, shape and strength of the ligament were studied. Following the autopsy examination, upper abdominal CT scans were reviewed to identify the ligament. The Ligament of Treitz is a thin membranous and weak structure varying in size and shape. It would not be recognized on a CT image. It would not prevent displacement of the duodenum by an extrinsic mass. Illustrations of the ligament of Treitz in anatomic textbooks often represent an inaccurate picture of the true size and relationship of the ligament to adjacent structures.