Idiopathic Non Cirrhotic Portal Hypertension with Portal Gastropathy: A Case Report

Idiopathic portal hypertension (IPH) is a rare disorder characterized by portal hypertension without a recognizable cause such as cirrhosis. It is clinically characterized by splenomegaly, features of hypersplenism, and increased portal or splenic venous pressure. Despite reported cases of IPH, the entity still remains fairly under diagnosed. We are reporting a case of a 27 years old female, with no significant comorbidities and addiction history, who presented with complains of vomiting coffee brown substance and passing black colored stool. Her abdominal CECT and ultrasonography findings were consistent with sequelae of portal hypertension, with normal hepatic architecture and splenomegaly. Transient elastography confirmed the absence of cirrhosis. Esophagogastroduodenoscopy revealed esophageal varices and band ligation was done. She symptomatically improved and was later discharged on nonselective beta blocker therapy. This case highlights the unique possibility of finding features of hypersplenism without any underlying hepatic pathology.