Asymptomatic Extrahepatic Portal Venous Obstruction: A Case Report

Area of Science:

• Gastroenterology
• Vascular Medicine
• Hepatology

Background:

• Extrahepatic portal venous obstruction (EHPVO) is a rare condition.
• Portal venous thrombosis can lead to serious complications like esophageal varices and bleeding.
• Hypersplenism is a common sequela of portal hypertension.

Observation:

• A 56-year-old female presented with pancytopenia and fatigue.
• Past medical history included acute calculus cholecystitis treated with partial cholecystectomy.
• Laboratory tests indicated hypersplenism; MRI confirmed EHPVO; endoscopy revealed grade IV esophageal varices.

Findings:

• The patient was diagnosed with EHPVO and significant esophageal varices.
• Endoscopic variceal banding was performed for bleeding prophylaxis.
• Beta-blockers were initiated for secondary prevention of gastrointestinal bleeding.

Implications:

• This case underscores the need for increased awareness and diagnostic vigilance for EHPVO.
• Standard management involves endoscopic therapy and pharmacological prophylaxis.
• Further research is needed to establish clear management guidelines for EHPVO.