A 53-year-old woman presented to the emergency department with a complaint of increasing colic-like abdominal pain for four days. History She had a congenital third-degree atrioventricular block that was managed with the implantation of a transvenous dual-chamber pacemaker 36 years ago. Extended length electrodes were used and implanted through the subclavian vein.
The device was implanted subcutaneously in a left epigastric pocket. The last generator replacement was done seven years ago. Palpation Pacemaker scar was free of irritation Slight tenderness in the right and left upper abdominal quadrant Examination Obese (BMI- 33.8 kg/m 2 ) Temperature- 37.7 0 C BP- 161/88 mmHg HR - Regular sinus rhythm at 88 beats/min ECG - Atrioventricular synchronous pacing Laboratory test C-reactive protein: Elevated (55 mg/L) CT scan (images provided) What could be the probable diagnosis for this…
