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"Based on its relation to the liver sinusoid, increased pressure of portal vein can occur at three levels: presinusoid, sinusoid ,and postsinusoid. Obstruction of the presinusoid veins can be caused by extra-hepatic condition such as venous thrombosis.

We reported a case of portal hypertension with esophageal varices bleeding was a result of obstruction due to thrombosis of the splenic vein and portal vein under hypercoagulant conditions due to thrombocyto-sis. The management of esophageal varices was sclerotherapy while for overcome the thrombosis the patient was given hydroxy urea."

"Ultrasonography examination is an one of examination that can be used to see the abnormality of portal vein system. The technology of ultrasonography examination has further developed especially after using of Doppler ultrasonography which could portray haemodynamic changes from portal vein in liver cirrhosis patient. From this examination we also could predict bleeding."

"Introduction: Portal hypertension may cause gastrointestinal complications; one of the most serious is a ruptured esophageal varices. Portal hypertension is also the main cause of hypersplenism, which in turn could lead to pancytopenia. Despite adequate therapy, some cases of hypersplenism could not be resolved. Partial splenic embolization (PSE) is an effective alternative method to treat this condition. Method: We reported two cases of hypersplenism treated with PSE. The first case was a 10- year-old girl with pancytopenia and a history of recurrent esophageal ligation. The second case was a 32-year-old man with recurrent episodes of hematemesis for two years before admission. Results: After the PSE procedure, the first patient’s white blood cell and platelet doubled in one month after procedure and stable at follow-up three months later, with no complaint of hematemesis. The second patient’s platelet doubled five days after the procedure. The first patient developed a complication of a splenic abscess, but after antibiotic administration and pus drainage, the condition was resolved. Conclusion: PSE is an effective method to treat hypersplenism secondary to the hypertensive portal. Treatment goals successfully achieved include improvement in blood count and control of bleeding. There are risks following PSE, but with adequate treatment, it can be overcome. Keywords: hypersplenism, partial splenic embolization, portal hypertension, pancytopenia"

"Diagnosis of non cirrhotic portal fibrosis was considered when the following criteria were fulfilled evidence of portal hypertension (oesophageal varices, hypersplenism, ascites, or increased hepatic venous pressure gradient), Doppler ultrasound showing patent portal and hepatic veins, and liver biopsy showing sign of cirrhosis. Non cirrhotic portal fibrosis clinically characterized by splenomegaly, anemia, portal hypertension, and histopathological examination portal tract showing fibrosis and sclerosis. Portal hypertension are most caused by a cirrhotic liver (85%), there are only a few reports on non cirrhotic portal hypertension, mostly in Japan and India. We reported a case of non cirrhotic portal fibrosis in young male. The clinical complications of portal hypertension are variceal bleeding and pancytopenia due to hypersplenism. Variceal band ligation and splenectomy were performed. The patient showed good clinical response"

"Non-Cirrhotic Portal Hypertension (NCPH) is a rare cause of hematemesis and melena. Like in cirrhotic patient, hematemesis in NCPH patient was caused by rupture of esophageal varices. But unlike in cirrhotic patient, in NCPH there are no sign of liver failure, because liver physiology is still normal. We reported case of male patient with NCPH that had hematemesis because of rupture of esophageal varices.

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Hipertensi portal non-sirosis merupakan salah satu penyebab dari hematemesis dan melena yang cukup jarang terdiagnosa. Seperti pada pasien sirosis hepatis, pada pasien dengan hipertensi portal non-sirosis, hematemesis dan melena terjadi karena ruptur varises esofagus. Namun berbeda dengan sirosis hepatis, pada pasien hipertensi portal non-sirosis tidak ada tanda-tanda gagal hati, yang merupakan ciri khas dari sirosis hepatis. Telah dilaporkan pasien pria dengan hipertensi portal non-sirosis yang mengalami hematemesis akibat ruptur varises esofagus"