ligament of treitz การใช้

Upper gastrointestinal series is the modality of choice for the evaluation of malrotation as it will show an abnormal position of the duodeno-jejunal flexure ( ligament of Treitz ).
It is an open technique where the jejunosotomy is sited 30 cm distal to the Ligament of Treitz on the antimesenteric border, with the catheter tunneled in a seromuscular groove.
During a Whipple's procedure, commonly used to treat pancreatic cancer by removing the pancreas, duodenum, and part of the jejunum, the ligament of Treitz is separated from the duodenum and preserved.
Witting found that nasogastric aspirate has sensitivity 42 %, specificity 91 %, negative predictive value 64 %, positive predictive value 92 % and overall accuracy of 66 % in differentiating upper GI bleeding from bleeding distal to the ligament of Treitz.
Risk factors include anatomic characteristics such as : aesthenic ( very thin or " lanky " ) body build, an unusually high insertion of the duodenum at the ligament of Treitz, a particularly low origin of the SMA, or intestinal malrotation around an axis formed by the SMA . Predisposition is easily aggravated by any of the following : poor motility of the digestive tract, rapid linear adolescent growth spurt, weight loss, starvation, catabolic states ( as with cancer and burns ), and history of neurological injury.