Cirrhosis or thrombosis of the portal vein can cause portal hypertension and gastric or esophageal varices. When a patient presents with hematemesis and has known liver disease the ABC’s of resuscitation and stabilization are undertaken and esophagogastroduodenoscopy (EGD) is performed. EGD can be both diagnostic (identifying varices) and therapeutic; sclerotherapy with an agent such as sodium moruate can stop the bleeding. Unfortunately, for active or diffuse esophageal hemorrhage from varices, the endoscopist is unlikely to be able to stop the bleeding at the first attempt.