<prompt> A young boy presented with severe hematemesis. On examination, there was no hepatomegaly, Mild splenomegaly is present. Endoscopy shows esophageal varices. The most probable diagnosis -Veno occlusive diseaseBudd chiari syndromeCirrhosis liverNon cirrhotic portal fibrosis  <response>: Splenomegaly, variceal bleeding in the absence of hepatomegaly suggest the diagnosis of non-cirrhotic portal fibrosis.Non-Cirrhotic Portal FibrosisIts incidence is very high in India accounts for 15 to 18 of all patients with portal hypertension. Aetiology :Infection It was suggested that E.coli can cause NCPFExposure to chemicals Chronic ingestion of Arsenic is incriminated in causing NCPE Vinyl Chloride toxicity can also cause NCPFClinical features :Symptoms :Patients are usually young in 3rd or 4th decade of life.Gastrointestinal haemorrhage is the most common presenting symptom seen in 60-90 of patients.Lump in the left side of Abdomen dt enlargement of the spleenJaundice Ascites uncommon and if they do occur it is for a short period of time. SignsSplenomegaly usually massiveThe liver usually normal in sizeSometimes mild ascites can be seen.Endoscopy :Esophageal varices are detected in over 90 of patientsRectal varices in 70 of patients. 