Chronic Extrahepatic Portal Vein Occlusion in a Young Patient.

Extrahepatic portal vein obstruction (EHPVO) is a rare condition characterized by the occlusion or narrowing of the portal vein outside the liver. We present a case report of a patient with EHPVO secondary to combined protein C and S deficiency and pancytopenia secondary to hypersplenism, highlighting the clinical presentation, diagnostic challenges, and management strategies. Early recognition of this condition and prompt initiation of appropriate treatment can prevent life-threatening complications such as variceal bleeding and portal hypertension. This case underscores the need for a high index of suspicion for inherited thrombophilias in patients presenting with portal vein thrombosis, particularly in the absence of traditional risk factors.

The 'forgotten disease' (or the never known).

Lemierre's syndrome is an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. Despite its rarity, it is important to have a high degree of clinical suspicion to recognise it early. A history of sore throat followed by metastatic infections and abscesses should alert the clinician to the possibility of this unusual infection. We present a case of Lemierre's syndrome presenting with meningitis in a previously healthy young adult along with a review of the pathophysiology of necrobacillosis and its diagnosis, diagnostic difficulty and treatment.