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.