First sign of Non cirrhotic portal fibrosis-
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
Upper GI bleeding
Ascitis
Splenomegaly
Jaundice
Oesophagus