Severe Proximal Celiac Trunk Stenosis Without Significant Aortic Atherosclerosis: A Case Report

A 76-year-old male with a history of gastritis, gastric ulcer perforation, hypertension, and active smoking presented with recurrent chest pain, abdominal pain, and back pain. Workup excluded acute coronary syndrome, pulmonary embolism, aortic dissection, and mesenteric ischemia. CT angiography revealed severe proximal celiac trunk stenosis, an ectatic descending thoracic aorta, bilateral renal cysts, emphysema, and a hepatic hypodensity. Further evaluation demonstrated non-obstructive coronary disease, possibly related to endothelial dysfunction. This case highlights the diagnostic complexity of back pain and chest pain in elderly patients with other comorbidities, emphasizing the importance of distinguishing incidental vascular findings from clinically significant pathology. A multidisciplinary approach involving cardiology, vascular surgery, gastroenterology, pulmonology, and nutrition services was required to optimize care.