Superior mesenteric artery syndrome is a rare abnormality caused by a congenitally short suspensory muscle.

[2] The suspensory muscle arises from the right crus of the diaphragm as it passes around the esophagus, continues as connective tissue around the stems of the celiac trunk (celiac artery) and superior mesenteric artery, passes behind the pancreas, and enters the upper part of the mesentery, inserting into the junction between the duodenum and jejunum, the duodenojejunal flexure.

[1] According to some authors, who use the original description by Treitz, the muscle may be divided into two sections: a ligamentous portion attaching the right crus of diaphragm to the connective tissue surrounding the coeliac artery and superior mesenteric artery; and a lower muscular portion from the connective tissue attaching to the duodenum.

[3][4] These two parts are now considered anatomically distinct, with the suspensory muscle referring solely to the lower structure attaching at the duodenum.

[6] It is an especially important landmark to note when looking at the bowel for the presence of malrotation of the gut, a syndrome often suspected in young children when they have episodes of recurrent vomiting.

[7] Superior mesenteric artery syndrome (SMA) is an extremely rare life-threatening condition that can either be congenital and chronic, or induced and acute.

SMA Syndrome is characterised by compression of the duodenum between the abdominal aorta and the superior mesenteric artery, and may—when congenital—result from a short suspensory muscle.