A 12 year old boy presents with hemetemesis, malena and mild splenomegaly. There is no obvious jaundice or ascitis. The most likely diagnosis is -

Ans is 'a' i.e., EHPVO Information in question are: i) Patient is 12 years male ii) Hematemesis, melena and mild splenomegaly --> signs of poal hypeension iii) No Jaundice or Ascitis So, the boy in question has poal hypeension. o Three most common causes of poal hypeension are: i) Extrahepatic poal vein obstruction (EHPVO) ii) Non-cirrhotic poal fibrosis (NCPF) iii) Cirrhosis. In cirrhosis, jaundice & ascitis are prominent. So, this option is ruled out. o Now we are left with EHPVO and NCPF. Both these causes non-cirrhotic poal hypeension, i.e. poal hypeension without signs of liver dysfunction. o Both these have similar clinical picture except for the age of presentation. EHPVO is usually seen in young male children (1st and 2nd decade) while NCPF is a disease of adults (25-35 years). So, best answer here is EHPVO.