Maldigestion of protein and fat is manifested in chronic pancreatitis only if the damage of pancreatic tissue exceeds?
**Core Concept**
Chronic pancreatitis is a progressive inflammatory disease of the pancreas leading to irreversible damage of pancreatic tissue, affecting both exocrine and endocrine functions. The extent of pancreatic damage determines the manifestation of malabsorption in chronic pancreatitis.
**Why the Correct Answer is Right**
Malabsorption of protein and fat in chronic pancreatitis occurs due to the destruction of pancreatic enzymes, particularly lipase, amylase, and trypsin. When the pancreatic tissue damage exceeds 90%, the production of these enzymes is significantly impaired, leading to maldigestion of proteins and fats. This is because the pancreas is unable to produce sufficient amounts of lipase to break down triglycerides into fatty acids and glycerol, and amylase to break down carbohydrates into simple sugars. As a result, undigested fats and proteins are not absorbed by the small intestine, leading to malabsorption.
**Why Each Wrong Option is Incorrect**
* **Option A:** 50% damage is not sufficient to cause significant malabsorption of protein and fat, as the pancreas still produces sufficient enzymes to digest these nutrients.
* **Option B:** While 70% damage does impair pancreatic function, it is not severe enough to cause significant malabsorption of protein and fat.
* **Option D:** There is no specific percentage of pancreatic tissue damage that is commonly cited as the threshold for malabsorption of protein and fat in chronic pancreatitis.
**Clinical Pearl / High-Yield Fact**
Recall that the severity of pancreatic damage in chronic pancreatitis correlates with the degree of malabsorption. Patients with more extensive pancreatic damage are more likely to experience malabsorption of protein and fat.
**Correct Answer: C. 90%**