EHPVO
(Extrahepatic Portal Venous Obstruction)
Trusted Hands for Portal Hypertension
Understanding EHPVO
Extrahepatic Portal Venous Obstruction (EHPVO) is a rare condition where the main portal vein outside the liver becomes blocked, leading to increased pressure in the portal venous system. This blockage can cause complications such as enlarged spleen, varices (enlarged veins in the esophagus or stomach), and risk of gastrointestinal bleeding. Early detection is important to prevent serious complications.
In simple terms, EHPVO is a blockage of the vein that carries blood to the liver from the intestines and spleen. This causes blood to reroute through smaller veins, increasing pressure and leading to symptoms like abdominal swelling, variceal bleeding, and enlarged spleen.
Often seen in children and young adults.
A major cause of non-cirrhotic portal hypertension.
When Should You Seek A Specialist
Symptoms Of EHPVO
Enlarged Abdomen or
Spleen
Persistent swelling or fullness in the left upper abdomen.
Gastrointestinal
Bleeding
Vomiting blood or passing black, tarry
stools.
Abdominal pain or discomfort
Abdominal pain or discomfort especially in the upper abdomen
fatigue or
weakness
Often due to anemia from blood loss or hypersplenism.
Easy Bruising or
Bleeding
Reduced platelet counts due to spleen
enlargement.
Growth or Developmental Delay in Children
Growth or Developmental Delay in Children is common in pediatric EHPVO.
Common Causes of EHPVO
Several factors contribute to portal vein obstruction outside the liver:
Blood Clotting Disorders
Thrombophilia or other clotting disorders increase risk of vein blockage.
Umbilical Vein Infection in Newborns
Infection in the umbilical vein can lead to clot formation in infants.
Abdominal Infections or Inflammation
Pancreatitis, appendicitis, or peritonitis may trigger thrombosis.
Congenital Abnormalities
Some patients are born with structural changes in the portal vein.
Unknown or Idiopathic Causes
In many cases, the exact cause is not identified.
How We Diagnose?
First-line imaging to detect portal vein blockage and blood flow changes.
Provides detailed visualization of portal vein obstruction and collateral veins.
Endoscopy detects esophageal or gastric varices at risk of bleeding.
Blood tests assess liver function, platelet counts, and screen for clotting disorders.
Treatment Options
Treatment focuses on managing portal hypertension and preventing complications:
Splenectomy
Surgical removal of the enlarged spleen to reduce hypersplenism, improve blood counts, and prevent repeated bleeding.
Endoscopic Therapy
Banding or sclerotherapy for varices to control or prevent gastrointestinal bleeding.
Medical Management
Beta-blockers to reduce portal pressure and prevent bleeding.
Shunt Surgeries
Procedures like mesocaval or splenorenal shunts divert blood flow from the high-pressure portal vein to other veins, reducing variceal bleeding risk.
Why Trust Us for Liver EHPVO Treatment?
Combined expertise of two leading liver surgeons
Dr. Vikas Patel has been part of more than 600 liver transplants, while Dr. Dharmendra Dangi has been part of over 500 liver transplants and performed 500+ complex liver and HPB surgeries. Together, they bring unmatched skill to even the toughest cases.
Experience with high-risk and pediatric cases
From critically ill adults to children needing delicate surgery, our team has successfully managed some of the most challenging and rare liver conditions. Both doctors are trained to manage challenging cases, including liver failure in children, elderly patients, and blood group mismatches.
Proven results using advanced techniques
We use the latest surgical and medical methods including minimally invasive procedures to ensure safer operations, faster recovery, and long-term success. Dr. Dangi is one of the few surgeons in India performing midline donor hepatectomy, a safer way to remove part of the liver from a living donor.
Nationally recognized for excellence
Our surgeons are trusted across India for their leadership in liver surgery. Their work has been featured in medical journals, presented at national conferences, and acknowledged in health magazines such as Silicon India (Top 10 Liver Transplant Surgeons, 2025).
OUR APPROACH
Accurate Diagnosis
using advanced imaging and testing
Personalized Treatment Plans
based on your stage and condition
Complete Pre & Post Transplant Support
when surgery is needed
A Multidisciplinary Team
Both surgeons jointly plan and perform procedures to ensure the best outcomes.
FAQ
Common Questions We Hear From Patients
Your concerns are valid. Here are expert answers to help you make confident decisions about your liver health.
It is a rare cause of portal hypertension, often seen in children and young adults, but it requires timely management to prevent complications.
Yes, with proper surgical intervention such as shunt surgeries or splenectomy, long-term outcomes are generally favorable.
With timely diagnosis and treatment, children can lead healthy lives, though regular follow-up is essential.
Newborns with umbilical vein infections, patients with clotting disorders, and those with prior abdominal infections are at higher risk.
Not always. It is recommended for patients with severe hypersplenism or repeated bleeding episodes.
Shunt surgeries redirect blood flow from the blocked portal vein to other veins, lowering pressure and preventing variceal bleeding.
Recurrence is rare after surgical correction but regular follow-up is necessary to monitor for complications.
Take the First step to a
Advanced Surgery, Better Survival
EHPVO is a complex condition that can lead to serious complications if left untreated. With timely diagnosis and expert surgical intervention, patients can achieve excellent outcomes and improved quality of life.
Talk to Ahmedabad’s Trusted Liver Experts
At our center, Dr. Vikas Patel and Dr. Dharmendra Dangi specialize in managing portal hypertension and EHPVO. With extensive experience in splenectomy, shunt surgeries, and expert liver care, patients receive safe, precise, and personalized treatment for lasting relief.