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Understanding EHPVO

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Abstract

Extrahepatic portal vein obstruction (EHPVO) is characterized by cavernomatous transformation of the extrahepatic portal vein leading to portal hypertension and its sequelae. This article reviews the etiology, clinical features, and the management of its sequelae. Most common presentation being about of hematemesis or growth retardation in children and in later childhood/early adult life, patients commonly present with variceal bleed, growth retardation, and hypersplenism. Asymptomatic EHPVO patients can be followed up. Patients with variceal bleed need endoscopic management, and surgery is indicated in those who fail endoscopy or who are not amenable to endoscopic management. Patients with symptomatic hypersplenism can be treated with interventional radiological procedures. Symptomatic portal biliopathy can be managed with ERCP in the acute setting and a decompressive shunt procedure with or without a biliary diversion as an elective procedure.

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  1. Department of Surgical Gastroenterology & Liver Transplant, Bangalore Medical College & Research Institute, Bangalore, India

    Nagesh N. Swamygowda, Rajesh Pendlimari & Kaushik Subramanian

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  1. Nagesh N. Swamygowda
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Swamygowda, N.N., Pendlimari, R. & Subramanian, K. Understanding EHPVO. Indian J Surg 83 (Suppl 4), 859–866 (2021). https://doi.org/10.1007/s12262-021-02833-y

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