A cirrhotic patient vomits blood; endoscopy shows bleeding esophageal varices. Cirrhosis scarred the liver — blood can't flow through, portal pressure rises, and collateral veins balloon in the esophagus (varices); one ruptured. Band ligation stops it acutely; beta-blockers lower portal pressure long-term. The same portal hypertension causes ascites (fluid weeps into the belly) and hemorrhoids. Variceal bleeding is cirrhosis's dramatic face — the scarred liver's plumbing rebellion.