Riverdoc is much more astute and a Doc, right? I worked under folks like Riverdoc.
My input would be just that. Riverdoc can validate or explain if I'm off in my thinking.
The elevated potassium can sometimes occur as a false positive if the cells in the blood draw rupture. The ruptured cells will leak their potassium and taint the results. Generally another draw is done to confirm a true reading, but that may not have been done in AC's case. Also, dehydration can elevate the potassium, and that may be a possibility considering his creatinine was elevated at 1.6. Creatinine is a measure of how well the kidneys are functioning. The kidneys work harder if there is dehydration. I relied strongly on that lab when doing contrast studies in CT. So, that is what I am guessing about the elevated potassium.
The multiple PE folci is the most common way that PE presents. It generally isn't just one. The single clot will fragment into smaller clots which then appear in different areas of the lung vessels. The lack of clots in the legs my be because they left no residual evidence behind, particularly if they traveled days before to the lungs.
What I found concerning were the large cavernous hemangiomas in the liver. In very rare cases, these hemangiomas can cause blood clots that lead to PEs. But it isn't common, so it is a small possible cause of the PEs and why there was no evidence of clots in the legs.
He definitely aspirated. I'm just not sure how much that may have contributed. (Riverdoc, what do you think?)
The lack of the anion-gap is concerning. Like RiverDoc said, that was a missed part of the puzzle, and I can't imagine why it wasn't done.