Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venous Thrombosis in a Child

Abstract

Extra hepatic portal vein obstruction (EHPVO) is the commonest cause of portal hypertension in children. EHPVO along with thrombosis of splenic vein (SV) and superior mesenteric vein (SMV) is an uncommon condition causing extensive varices formation in the oesophagus, stomach and in other parts of gastrointestinal tract including rectal varix as well as splenomegaly and associated hypersplenism. Most commonly the child presents with hematmesis and due to extensive varices it is difficult to obliterate the varices using endoscopic therapy. Due to thrombosed SMV and SV shunt surgery is not possible. We describe here a case of EHPVO with SMV and SV thrombosis with bleeding gastric varix that underwent gastro- oesophageal devascularisation with splenectomy and oesophageal transection to prevent recurrent bleed from gastric varices.