<prompt> Ramu, a 8 yr old boy presents with upper GI bleeding. On examination, he is found to have splenomegaly; there are no signs of ascites, or hepatomegaly; esophageal varices are found on UGIE Most likely diagnosis is -Budd chiari syndromeNon cirrhotic poal hypeensionCirrhosisVeno-occlusive disease  <response>: Ans. is b i.e., Non cirrhotic patial hypeension o Clues in this question are ? i Upper GI bleeding from esophageal varices iii No ascites or hepatomegaly ii Splenomegaly iv No jaundice o All these indicate Non-cirrhotic poal hypeension. o Two most common causes of extrahepatic poal hypeension are i NCPF seen in adults ii EHPVO -- seen in children o So, this is a case of non-cirrhotic poal hypeension due to EHPVO. About other options ? o In Budd-chiari syndrome Hepatic vein thrombosis and venocclusive disease, there will be hepatomegaly, jaundice and ascites. o In cirrhosis, jaundice and ascites will be seen. 