{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:40:23Z","timestamp":1756377623749,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,2,26]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>Median arcuate ligament syndrome (MALS) is a rare clinical entity arising from the extrinsic compression of the coeliac axis by the median arcuate ligament. In this report, we detail a unique presentation involving monozygotic twins, both of whom demonstrated anatomical extrinsic compression of the coeliac axis by the median arcuate ligament. Intriguingly, only one twin manifested clinical symptoms consistent with MALS, despite comparable anatomical compression of the coeliac axis observed in both. This case highlights the potential interplay of a genetic or anatomical predisposition to coeliac axis compression and secondary, possibly environmental, factors that lead to the development of clinical symptoms. In this report, we explore various determinants potentially influencing symptomatology in MALS and advocate for the publication of similar case studies to further elucidate this rare condition.<\/jats:p>","DOI":"10.1136\/bcr-2024-259684","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T13:47:02Z","timestamp":1710251222000},"page":"e259684","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Identical anatomy, different symptoms: a comparative case study of median arcuate ligament syndrome in monozygotic twins"],"prefix":"10.1136","volume":"17","author":[{"given":"Lakmali","family":"Anthony","sequence":"first","affiliation":[{"name":"Vascular Surgery, Northern Health NCHER, Epping, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeline","family":"Gillies","sequence":"additional","affiliation":[{"name":"Western Health, Footscray, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iman","family":"Bayat","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Northern Hospital, Epping, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"2025082803120682000_17.3.e259684.1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1001\/jamasurg.2016.0002","article-title":"Median arcuate ligament syndrome-review of this rare disease","volume":"151","author":"Kim","year":"2016","journal-title":"JAMA Surg"},{"key":"2025082803120682000_17.3.e259684.2","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1016\/j.jvs.2019.11.012","article-title":"Median arcuate ligament syndrome","volume":"71","author":"Goodall","year":"2020","journal-title":"J Vasc Surg"},{"key":"2025082803120682000_17.3.e259684.3","doi-asserted-by":"publisher","DOI":"10.1148\/rg.255055001"},{"key":"2025082803120682000_17.3.e259684.4","doi-asserted-by":"crossref","DOI":"10.4293\/JSLS.2022.00067","article-title":"Median arcuate ligament syndrome is effectively relieved with minimally invasive surgery","volume":"26","author":"Birkhold","year":"2022","journal-title":"JSLS"},{"key":"2025082803120682000_17.3.e259684.5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.4067\/S0717-95022008000200008","article-title":"A review on the celiac trunk compression syndrome: some anatomic clinical-surgical aspects","volume":"26","author":"Petrella","year":"2008","journal-title":"Int J Morphol"},{"key":"2025082803120682000_17.3.e259684.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2008.11.005"},{"key":"2025082803120682000_17.3.e259684.7","first-page":"268","article-title":"Neurally mediated syncope","volume":"27","author":"Zaqqa","year":"2000","journal-title":"Tex Heart Inst J"},{"key":"2025082803120682000_17.3.e259684.8","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1002\/ca.22773","article-title":"Median arcuate ligament syndrome: predictor of ischemic complications","volume":"29","author":"Arazi\u0144ska","year":"2016","journal-title":"Clin Anat"},{"key":"2025082803120682000_17.3.e259684.9","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199808000-00039"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-259684","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:12:12Z","timestamp":1756375932000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-259684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":9,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,12]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bcr-2024-259684"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-259684","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,3]]}}}