Which clinical scenario would most directly impair the delivery of absorbed monosaccharides from the intestine to the liver?

• A. Severe atrophy of the gastric mucosa, which would directly block monosaccharide transport across enterocytes in the jejunum, an anatomically mismatched impact because gastric mucosa does not perform small intestinal absorption.
• B. Obstruction of the thoracic duct, which would prevent monosaccharide transport to the liver by blocking lymph flow carrying sugar-loaded chylomicrons, a misunderstanding since monosaccharides are transported in blood not lymph.
• C. A defect in pancreatic lipase secretion, leading to immediate failure of monosaccharide absorption, which confuses lipid digestion enzymes with carbohydrate absorption processes.
• D. Thrombosis of the hepatic portal vein, because it would obstruct direct venous flow from the intestines to the liver and disrupt first-pass hepatic metabolism of absorbed monosaccharides.

Answer: (D)