Critical care nurse here. The answer is esophageal varices.
It's the same physiological anomaly as hemorrhoids, except in your esophagus. Swollen, fragile veins caused by increased internal pressure. In the case of hemorrhoids, that pressure inside the veins is caused by straining too much when trying to poo. In esophageal varices, the increased pressure inside the esophageal veins comes from blood backing up from a swollen, scarred, and damaged liver. So we often see esophageal varices in end stage alcohol use disorder.
Horror stories abound in emergency departments and ICUs of having to do CPR on a patient massively hemorrhaging out of their mouth from esophageal varices. As soon as nurses I know saw this report, our immediate thought was, "Yep, varices."
https://my.clevelandclinic.org/health/diseases/15429-esophageal-varices
Good morning! Oh man, Screech is coming on strong out of the locker rooms after halftime. Chestnut Backed Owlet and Buff Fronted going for the aggressive offense on this play.