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Portal hypertensive biliopathy: Nomenclature, aetiopathogenesis, diagnosis and management
  1. Radha K Dhiman (rkpsdhiman{at}hotmail.com)
  1. Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    1. Arunanshu Behera
    1. Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
      1. Yogesh Kumar Chawla (ykchawla{at}hotmail.com)
      1. Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
        1. Jang B Dilawari (jdilawari{at}hotmail.com)
        1. Department of Gastroenterology, Inver Clyde Royal Hospital, Greenock, United Kingdom
          1. Sudha Suri
          1. Department of Radiodiagn, Postgraduate Institute of Medical Education and Research, Chandigarh, India

            Abstract

            Extrahepatic portal venous obstruction (EHPVO) is a common cause of portal hypertension in the Third World and constitutes up to 40% of all patients with portal hypertension.[1,2] EHPVO is a common cause of major upper gastrointestinal bleeding among children.[2-4] The most common presentation in a child is well tolerated variceal bleeding and splenomegaly. In adults, EHPVO is often recognized while evaluating for other disorders or with uncommon presentations such as jaundice, pruritus, acute cholecystitis - like syndrome, ascites, etc resulting from prolonged portal hypertension.[5-7] The portal vein in EHPVO is transformed into a cavernoma, which is a bunch of multiple collateral veins around the obstructed portion of portal vein (Figure 1). Marked improvements in the management of variceal bleeding in EHPVO patients has resulted in an improved survival, hence, presenting with unusual symptoms in adulthood.

            • cholestasis
            • gallbladder varices
            • obstructive jaundice
            • portal biliopathy
            • pseudosclerosing cholangitis

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