W. Michael Park, MD

Ever wondered why surgeons obsess over a tiny “ligament” that’s actually a clever muscle hybrid hanging from your diaphragm? It quietly divides your gut’s bleeding zones and keeps your small bowel from twisting into chaos! The Ligament of Treitz—more accurately termed the suspensory muscle of the duodenum—marks the precise anatomical transition from the duodenum to the jejunum at the duodenojejunal flexure. Far from a simple collagenous ligament as its name suggests, this fibromuscular structure comprises a superior portion of skeletal (striated) muscle fibres arising from the right crus of the diaphragm, blending into connective tissue near the coeliac artery, and an inferior part of smooth muscle fibres originating from the third and fourth duodenal segments. This unique composition allows it to suspend and stabilise the flexure, widening the angle during contraction to facilitate smooth passage of intestinal contents into the mobile jejunum. Clinically, it serves as a critical landmark: bleeding proximal to the ligament is classified as upper GI (often presenting as haematemesis or melaena), while distal bleeding counts as lower GI (typically haematochezia). Surgeons rely on it during laparotomy to identify the jejunum for procedures like feeding jejunostomy or measuring bowel length.

Fat Perez draining Tiger's famous putt on 17 was a scene. 😂

@MayoClinicCVS I remember this being presented in vascular conference with Drs. Kenneth Cherry and my co-fellow Todd Rasmussen -with a classic illustration by David Factor.

In this case report, A. Pochettino, MD & other experts discuss ascending aorta to iliac artery bypass in coral reef aorta w/multidrug resistant hypertension & worsening renal function: #JournalofVascularSurgeryCasesInnovationsandTechniques dx.doi.org/10.1016/j.jvsc…

@georgetolisjr Podium jockies of questionable surgical skills giving lectures is an age old problem. It’s like being lectured in golf by a bogey golfer dressed up like a pro.

Cardiac surgical societies should require all “experts” to turn in a case list before they can sit on a national meeting panel and lecture the audience about “how I do it” or “how I teach it”.

It is a great tournament with a great field on a Pete Dye course that isn’t not fun to watch. But Buc-ees is great too but it doesn’t go asking for Michelin stars.

@NoLayingUp is the Players the fifth major? They’ve been talking about this since the 80’s when I was growing up in Jax. I say no.

@NUCLRGOLF No way to get tortured on a Pete Dye track designed with a disco era sensibility like the old clubhouse they demolished.

⛳️💰😮‍💨 Would you pay $875 to play a round at TPC Sawgrass? #THEPLAYERS

Some alien civilization observing us must be saying "bipedal, one head, two arms, don't over feed -they don't know when to stop, don't put too many into the same box -they'll kill each other and overpopulate."

Just heard that a resident survived a horrific home invasion because she fought back in the most impressive way. After speaking to her mentors I learned that she had a message for everyone (highlighted at the end of this report)- fight like hell Amplify: atlantanewsfirst.com/2026/02/19/dek…

@DrDAgarwal @grok when a physician speaks to another physician who represents a health insurance company in another state, and that out of state physician denies payment for that care, isn’t that out of state physician practicing medicine across state lines by rendering that decision?

I just did a peer to peer with a large insurance company for botox at the time of HoLEP to help mitigate postop urinary urge. Of course the request was denied. The doctor on the other end refused to give me her first name!!! Anyone run into this?

@Golfingbrock Meh. To get engagement, insert an amateur team with handicaps. Guaranteed some obese loudmouth with a “16” handicap could become a national hero.

I have watched countless tour events, majors and Ryder Cups over the years, and I have never seen a celebration as big as this SIM ace. Where does this rank among the greatest shots of all time?

.⁦@HarringtonHVI⁩ Vascular Center happy hour. East side of Cleveland edition. Could not ask for a more collaborative group of APPs RNs admins docs and RVTs! ⁦⁦@docpark⁩ ⁦@JaeChoMD⁩

@jamierkennedy Loren Roberts

Name a 1990s golfer that time has forgotten....

@PGATOUR I remember a Bobby Jones film where he demonstrated a high draw with a three wood that stopped on a dime with 1940’s equipment.

Does your 3-wood land as soft as this? 😳 Wyndham Clark makes it look easy from 271 yards. 📺 Golf Channel

Good luck to all who took the VSITE yesterday! If we missed any topics so @michaelsgroi15 and I can include them in upcoming versions! a.co/d/0855FFh8

@MazinFotehMD @SusumuOshima The worst is when I see things like venoplasty and stenting of VTOS when there are clear reasons why surgery is necessary. A parallel graft EVAR when a branched one or open surgery better.

Mike, what I think your trying to say is this, we are in an era of undertrained open vascular surgeons. Many have no idea how to safely perform major open vascular surgery. In response, they offer what they know, endo. Endo in my honest opinion is rarely curative, much like a Bandaid. Peel the cover back, the wound is still there.

"Durable treatment is mandatory for aortic diseases"- Insight from Prof. Morad's visit to KAC Today: A patient deemed "cured" after TEVAR at a university hospital. Reality: 80mm aortic aneurysm requiring emergency open surgery. The issue isn't the device—TEVAR is excellent for appropriate cases. The issue is system failure: Complex cases in young patients need referral to centers capable of durable open repair BEFORE attempted endovascular "solutions." "Can do" ≠ "Should do" We need courage to choose the RIGHT treatment, not just the AVAILABLE treatment. We need courage to refer patients to appropriate centers. This is what patient-centered care truly means. 600 open TAAA cases/year taught me this lesson repeatedly. #AorticSurgery #TEVAR #OpenRepair #DurableTreatment

@ALMannixMD We are on the same side fighting a battle that can’t be won, but we do so anyway.

Consultants: we don’t expect you to know how to intubate, run a code, reduce a fracture, deliver a baby, or actively manage 30 patients simultaneously. Please don’t expect us to know every nuance of your specialty, either. That’s why we call.

This isn’t a time to bicker over the Battle of the Tours. This is the time to appreciate a truly remarkable story of perseverance. Anthony Kim was one of my favorite players as a kid. Then he disappeared and re-emerged more than a decade later looking like a completely different person. Today he's showing us that DOG is still in there. Big time.