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A Moment in History 
Václav Treitz
Dr. Václav Treitz
(1819 - 1872) 

Also known as Wenzel Treitz, Dr. Václav Treitz was born in Hostomice, Bohemia. He attended the Charles-Ferdinand University in Prague studying humanities and medicine, receiving his medical degree in 1846. Treitz started postgraduate work at the Vienna General Hospital (Allgemeines Krankenhaus), where Joseph Skoda (1805-1881) was a proponent of “therapeutic nihilism” which stated that “drug treatment usually does more harm than good”, so a minimalistic or even pessimistic approach to diseases was used.

Large numbers of women at this hospital died of “puerperal fever” an postpartum uterine infection due to contamination by the unwashed hands of physicians and utter lack of cleanliness (septic technique had not been yet described). It was during Treitz’s time at the Vienna General Hospital that Ignaz Philipp Semmelweis (1818 – 1865) stated his initial observations on asepsis. Treitz later became a follower of Semmelweis’ and Lister’s teachings and techniques.

In 1852 Treitz was appointed Professor of Pathological Anatomy in the Jagellonian University in Prague.

In 1853 he published a paper ("Ueber einen neuen Muskel am Duodenum des Menschens" ) describing a new muscle he discovered at the duodenojejunal junction, later to be known as the eponymic “muscle of Treitz”; the fold of peritoneum over the muscle of Treitz is known today as the "ligament of Treitz". Treitz also described a paraduodenal retroperitoneal hernia that occurs at the paraduodenal recess, just lateral to the ligament of Treitz.

A staunch proponent of Czechoslovakian independence and language, Treitz was publicly attacked for his medical theories and nationalistic beliefs. Isolated and depressed, Treitz committed suicide in 1872.

1. "Václav Treitz (1819-1872): Czechoslovakian Pathoanatomist and Patriot” Fox, RS; Fox, CG; Graham, WP. World J. Surg. 9, 361-366, 1985
2. "Treitz of the ligament of Treitz". Haubrich, W S. (2005) Gastroenterology, 128 (2), 279
3. "Preserving Treitz's muscle in hemorrhoidectomy". Gemsenjäger, E Diseases of the Colon & Rectum (1982), 25 (7), p. 633.
4. “The Muscle Of Treitz And The Plica Duodeno-Jejunalis” Crymble, PT. The British Medical Journal, Vol. 2, No. 2598 (1910), 1156-1159
Original image courtesy of Wikipedia.org.

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Ligament of Treitz

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The ligament of Treitz is formed by a fold of peritoneum over the suspensory muscle of the duodenum. This muscle is also known as the "muscle of Treitz" or "musculus suspensorius duodenii". This muscle was first described in 1853 by Dr. Václav Treitz. 

The muscle (see image #1) has an unusual in structure in that it is formed by a tendon with two muscular ends  of dissimilar embryological origin and function. The superior muscular component is skeletal (voluntary) muscle and arises as a slip of muscle (Hilfsmuskel) from the right esophageal crus of the respiratory diaphragm, as well as muscular and ligamentous fibers arising in the region of origin of the celiac trunk and superior mesenteric artery. The inferior portion of the muscle is smooth (involuntary) muscle and has been described as continuous with both the longitudinal and circular muscle layer of the intestine at the duodenojejunal junction.

Anterior view of the duodenum and the suspensory muscle of the duodenum
Click on the image for a larger version
Original image by Dr. Vaclav Treitz
The ligament of Treitz is an anatomical landmark used by anatomists and surgeons to denote the duodenojejunal junction and the point where the small intestine passes from retroperitoneal duodenum to intraperitoneal jeunum. Surgeons use the ligament of Treitz to measure the jejunum to decide where to perform an anastomosis.Click on the gray bar below the image to see the original sketch published by Dr. Václav Treitz in his 1853 publication "Ueber einen neuen Muskel am Duodenum des Menschens" (On a new muscle in the duodenum of man). The 'muscle of Treitz" is marked by an arrow.

Clinical anatomy, pathology, and surgery of the gastrointestinal tract are some of the many lecture topics developed and delivered to the medical devices industry by Clinical Anatomy Associates, Inc.

"Clinically Oriented Anatomy" Moore, KL. 3r Ed. Williams & Wilkins 1992
2. "The origin of Medical Terms" Skinner, AH, 1970
3. "The suspensory muscle of the duodenum and its nerve supply" Jit, I.; Singh, S. J. Anat. (1977), 123, 2, pp. 397-405
4. "Anatomical and functional aspects of the human suspensory muscle of the duodenum." Costacurta, L. Acta Anat (Basel). 1972;82(1):34-46
Image property of: CAA.Inc. Artists: Dr. E. Miranda and D.M. Klein