First sign of Non cirrhotic portal fibrosis-: (A) Upper GI bleeding, (B) Ascitis, (C) Splenomegaly, (D) Jaundice
Answer is A. Ans. is 'a' i.e., Upper G1 bleedingo Splenomegaly, variceal bleeding and absence of any abnormality in the liver in a young adult suggests the diagnosis of Non cirrhotic portal fibrosis (NCPF).o Remember extrahapatic portal venous obstruction also presents with similar features but the important features to distinguish b/w these two conditions is, age of the patient Age of presentation :EHPVO - Children (1st to 2nd decade)NCPF - Young adult (2nd to 3rd decade)Comparison between NCPF and EHPVOSimilaritiesDifferenceo Massive variceal bleedingo Age of presentationEHPVO- ChildrenNCPF - Young adulto Moderate to massive Splenomegalyo Normal liver on histology'o Absence of Asciteso Site of obstruction in the portal venous system EHPVO - Main and 1st order branches of portal veinNCPF - Smaller 3rd and 4th order branches of portal vein are involvedo Normal liver function