The post-sinusoidal obstruction to portal flow of alcoholic cirrhosis raises the pressure in the portal system. The pressure is transmitted to the esophageal submucosal veins via the right and left (coronary) gastric, splenic, gastroepiploic and short gastric veins. The connection of the esophageal plexus of veins to the azygous veins in the chest is a natural porta-systemic route of decompression. The bulging esophageal varices are subject to erosion by passing food, resulting in massive bleeding.