Table 1:

Case Synopsis.

Case Number	Decedent Information	Initial Presentation	Medical History	Pancreas Exam	Antemortem Testing	Postmortem Serum Testing	Cause of Death	Time Between LKA/Pronounced Dead to Autopsy
1	47 yowm	Found dead; two-day history of vomiting	Diabetes mellitus; obesity	Focal hemorrhage;+ fat necrosis; acute inflammation	N/A	Amylase: 1817 U/L Lipase: 5080 U/L	I – Acute hemorrhagic pancreatitis II – DM; cardiomegaly; obesity	34 to > 40 hours
2	24 yowm	Found unresponsive; recent abdominal pain; drinking large amount of water	Obesity	Multifocal hemorrhage; + fat necrosis; acute inflammation	ED blood glucose: >1200 mg/dL TG: 1715 mg/dL	Amylase: 1920 U/L Lipase: 6606 U/L	I – Acute hemorrhagic pancreatitis with acute DM, due to hyper-triglyceridemia II – Morbid obesity	20 hours
3	46 yowm	Found unresponsive after complaining of abdominal pain; recent alcohol binge	Hypertension	Multifocal areas of fat necrosis, with fibrosis & scattered hemorrhage; acute and chronic inflammation	N/A	Amylase: 364 U/L Lipase: 1159 U/L	I – Acute & chronic pancreatitis II – Hypertensive & atherosclerotic cardiovascular disease	18 to 20 hours
4	57 yowm	Presented to ED after not feeling well for one week; increased thirst	None	Swollen and hemorrhagic; venous thrombosis; necrosis; acute inflammation	ED blood glucose: 1357 mg/dL Amylase: 119 U/L Lipase: 6485 U/L	Amylase: 268 U/L Lipase: >15 000 U/L	Acute hemorrhagic pancreatitis, with acute diabetic ketoacidosis, related to hyper-triglyceridemia	18 hours
5	30 yowm	Found dead on couch; recent complaints of feeling ill	Chronic alcoholism	Swollen and hemorrhagic; + fat necrosis; acute inflammation	N/A	Amylase: 2100 U/L Lipase: 9580 U/L	I – Acute hemorrhagic pancreatitis II – Chronic alcoholism	37 to 68 hours

LKA – Last known alive

yowm – Year old white male

N/A – Not applicable

DM – Diabetes mellitus

ED – Emergency department

TG – Triglycerides