Short and Hypertrophic Ligament of Treitz: A Rare Cause of Superior Mesentric Artery Syndrome

Superior mesenteric artery syndrome (SMAS) is a rare form of upper intestinal obstruction in which the third part of the duodenum is compressed between the superior mesenteric artery and the aorta, secondary to any condition decreasing the angle between these two arteries. We recently cared for a young male who came with features of proximal small bowel obstruction. On investigation, there was extrinsic duodenal obstruction. Exploratory laparotomy was done which revealed a short and hypertrophic ligament of treitz leading to compression of 3(rd) part of duodenum. Release of the ligament with doudenojejunostomy was done. Postoperatively, patient recovered well. This case report highlights the occurrence and importance of hypertrophic and contracted ligament of treitz as a rare cause of SMAS.