Which statement about portal hypertension is true?

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Portal hypertension arises from increased resistance to blood flow through the portal system, most commonly due to liver architecture disruption from cirrhosis. Cirrhosis thins and fibroses the hepatic sinusoids, raising intrahepatic resistance and the portal pressure. Schistosomiasis is another known cause, producing periportal (presinusoidal) fibrosis that constricts portal tracts and elevates portal pressure even when liver function is relatively preserved. This is why the statement that portal hypertension is caused by cirrhosis and schistosomiasis is true.

Other options are not correct because portal hypertension is not an impossible companion of liver disease, pancreatitis does not typically drive portal hypertension, and it is not exclusively due to portal vein thrombosis—PVT can cause it, but several other etiologies (notably cirrhosis and schistosomiasis) are common.