A 8 year old girl from Bihar presented with three episodes of massive hematemesis and melena. There is no history of jaundice. On examination, she had a large spleen, non-palpable liver and mild ascites. Poal vein was not visualised on ultrasonography. Liver function tests were normal and endoscopy revealed esophageal varices. The most likely diagnosis is:

**Core Concept**
The underlying principle being tested is the diagnosis of a condition causing portal hypertension in a child, leading to esophageal varices and massive hematemesis. This involves understanding of **portal vein thrombosis**, **liver cirrhosis**, and **extrahepatic portal vein obstruction (EHPVO)**.

**Why the Correct Answer is Right**
The correct answer is likely related to EHPVO, given the presence of esophageal varices, massive hematemesis, and a large spleen without liver dysfunction. The absence of jaundice and normal liver function tests point away from liver cirrhosis. EHPVO often results from **thrombosis of the portal vein**, which can occur in the absence of cirrhosis, especially in children.

**Why Each Wrong Option is Incorrect**
**Option A:** This could be a condition like liver cirrhosis, which typically presents with jaundice and abnormal liver function tests, not seen in this patient.
**Option B:** This might represent a different diagnosis not fitting the clinical picture of portal hypertension without liver disease.
**Option D:** This could be another condition that does not match the combination of splenomegaly, esophageal varices, and normal liver function.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that EHPVO is a common cause of portal hypertension in children, often presenting with hematemesis and splenomegaly without signs of liver disease.

**Correct Answer:** D. Extrahepatic portal vein obstruction.

✓ Correct Answer: D. Poal hypeension due to extrahepatic obstruction