A 5 year boy presented with massive haemetemesis. He is not febrile. Per abdomen examination revealed massive splenomegaly without hepatomegaly. Most probable diagnosis would be: March 2005: (A) Non-cirrhotic poal fibrosis, (B) Extrahepatic poal venous obstruction, (C) Budd-Chiari syndrome, (D) Hepatic carcinoma
Answer is B. Ans. B: Extrahepatic poal venous obstruction Patients with EHPVO usually presents at about 5-6 years with hematemesis with or without melena. Splenomegaly is almost universal in patients with EHPVO and size of spleen is usually dependent on the duration of the illness. Liver is usually normal in size. Ascites is usually rare.