Variceal haemorrhage occurs from dilated veins at the junction between the portal and systemic venous systems. Varices tend to be in the distal oesophagus and/or the proximal stomach, but isolated varices may be found in the distal stomach, large and small intestine. The majority of patients with variceal bleeding have chronic liver disease. Bleeding is characteristically severe and may be life-threatening. The size of the varices and their tendency to bleed are directly related to the portal pressure, which is usually directly related to the severity of underlying liver disease.