Background: The most typical presentation of extrahepatic portal hypertension is variceal bleeding. Besides this,splenomegaly, ascites, jaundice due to portal biliopathy, and hypersplenic features may be present. Portal veinthrombosis is a common cause of extrahepatic portal hypertension. 

Objectives: To observe the presentation, aetiology,treatment modalities, and hospital outcomes of extrahepatic portal hypertension in children. 

Methods: It was a crosssectionalstudy conducted at the Department of Pediatric Gastroenterology & Nutrition of Bangabandhu SheikhMujib Medical University (BSMMU), Dhaka. A total of 50 cases of extrahepatic portal hypertension were includedin this study with normal liver function tests and no signs of chronic liver disease (CLD). Clinical characteristics,laboratory and imaging profile of the cases, etiologies, endoscopic findings, variceal ligation, complications andhospital management were studied. 

Results: The majority (64%) of patients were male. The mean age at presentationwas 9.42 ± 3.55 years. Hematemesis in 46 (92%), Melaena in 45 (90%) and Splenomegaly in 49 (98%) patientswere observed. Features of pancytopenia in 18% of patients with portal vein thrombosis in 68% of patients wereexplored. Endoscopy of upper GIT showed 64% of cases had grade- 4 and 34% grade- 3 esophageal varices. Therewere no significant complaints in 47 (94%) patients with EVL, except four (8%) patients complained of chest pain.

Conclusion: Gastrointestinal bleeding and Splenomegaly were two standard clinical features of extrahepatic portalhypertension and portal vein thrombosis was the leading cause of it. This study underscores the importance of furtherresearch in this area, and a prospective study with a larger sample size is recommended to strengthen the presentfindings.