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Extrahepatic Portal Venous Obstruction: Revisiting an Old Entity With NewPerspectives
Surender Singh1, Rajanikant R Yadav2, Radha K Dhiman1
1Department of Hepatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Abstract:
Extrahepatic portal venous obstruction (EHPVO) remains a leading cause of non-cirrhotic portal hypertension in developing countries, especially among children and adolescents. Characterized by chronic extrahepatic portal vein thrombosis with cavernomatous transformation, it leads to recurrent variceal bleeding, hypersplenism, and portal biliopathy. Advances in imaging and interventional techniques have revolutionized management. This review synthesizes recent evidence on epidemiology, etiopathogenesis, diagnostic approaches, and therapeutic strategies, with emphasis on contemporary endovascular recanalization techniques, updated management of portal cavernoma cholangiopathy based on recent studies, and differentiation of pediatric versus adult management priorities, providing new perspectives relevant to tropical regions where EHPVO remains a major health burden.
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