This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Oesophagus, Subject name: Surgery
First sign of Non cirrhotic portal fibrosis- 
Select and explain. 
A. Upper GI bleeding, B. Ascitis, C. Splenomegaly, D. Jaundice
A: Upper GI bleeding
Answer: A: Upper GI bleeding 
Explanation: 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