A 50-year-old man with chronic alcohol use presents with acute epigastric pain radiating to the back. Serum lipase is markedly elevated. At autopsy, chalky white deposits are seen in the peripancreatic fat. What is the biochemical mechanism underlying these deposits?
- A Lipase-mediated hydrolysis of triglycerides with calcium soap formation ✓
- B Denaturation of tissue proteins by activated trypsin
- C Complement-mediated lysis of adipocyte cell membranes
- D Free radical-induced lipid peroxidation of adipocyte membranes
Correct answer: A. Lipase-mediated hydrolysis of triglycerides with calcium soap formation
Explanation
In acute pancreatitis, released lipase hydrolyzes triglycerides in peripancreatic fat into free fatty acids, which combine with calcium to form insoluble calcium soaps (saponification). These appear as chalky white deposits. This is enzymatic fat necrosis, distinct from traumatic fat necrosis or free radical injury.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.