Morbid Obesity Associated with Non-Alcoholic Fatty Liver Disease and Complicated by Severe Non-Cirrhotic Portal Hypertension: A Case Report from Rural Kenya

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease and is closely linked with obesity and metabolic syndrome. Portal hypertension in NAFLD typically occurs in the cirrhotic phase of the disease and may present with esophageal varices, splenomegaly with splenic sequestration syndrome, ascites, and features of liver failure. However, recent experimental and clinical data show the occurrence of portal hypertension in NAFLD in the absence of fibrosis or cirrhosis. We present such a clinical case from rural Kenya in this study with the literature review that proposes novel mechanisms for such non-cirrhotic portal hypertension in NAFLD.