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Obstructive jaundice in a case of portal hypertension.

A 21-year-old man presented with history of progressive jaundice with pruritis for 1 year with a rapid increase in the last month. On presentation the patient had haematemesis with a past history of multiple similar episodes. On examination the patient was icteric and had moderate splenomegaly. Laboratory investigation demonstrated a raised serum bilirubin (total bilirubin, 5.6 mg%; direct, 3.5 mg%), and the liver enzymes were also raised (alkaline phosphatase, 1014 U l, SGOT, 106 U l, SGPT, 72 U l). Following are the ultrasound (with colour Doppler) (Figure 1) and CT–abdomen (plain and contrast) (Figures 2 and 3) images. What is the diagnosis? What is the cause of obstructive jaundice?