Ramu, a 8 yr old boy presents with upper GI bleeding. On examination, he is found to have splenomegaly; there are no signs of ascites, or hepatomegaly; esophageal varices are found on UGIE Most likely diagnosis is -

Ans. is 'b' i.e., Non cirrhotic patial hypeension o Clues in this question are ? (i) Upper GI bleeding from esophageal varices (iii) No ascites or hepatomegaly (ii) Splenomegaly (iv) No jaundice o All these indicate Non-cirrhotic poal hypeension. o Two most common causes of extrahepatic poal hypeension are (i) NCPF seen in adults (ii) EHPVO --> seen in children o So, this is a case of non-cirrhotic poal hypeension due to EHPVO. About other options ? o In Budd-chiari syndrome (Hepatic vein thrombosis) and venocclusive disease, there will be hepatomegaly, jaundice and ascites. o In cirrhosis, jaundice and ascites will be seen.