Sudden Death Due to Hypercoagulability in a Patient With Pancreatic Cancer and Diabetic Ketoacidosis

Pancreatic cancer is a significant contributor to cancer-related mortality, with an increasing incidence linked to an aging population. A rare complication of pancreatic cancer is diabetic ketoacidosis (DKA), which arises from the tumor's impairment of insulin production. DKA can also present alongside other challenges such as malnutrition and hypercoagulability. This study describes a 67-year-old female patient with a past medical history of type 2 diabetes who presented with DKA and was later diagnosed with a pancreatic mass suggestive of malignancy. She developed multiple venous thrombi and subsequent pulmonary emboli, leading to sudden death. Autopsy revealed extensive occlusive thrombi and ischemic changes, emphasizing the potentially life-threatening interactions between DKA, malignancy-associated hypercoagulability, and metabolic derangements of pancreatic cancer. This study reinforces the need for careful monitoring and management of thrombotic events in patients with multiple comorbidities.