An unusual cause of hematemesis: Goiter

Figure 4 Venous blood flow of the downhill varices in relation to goiter. 1: internal jugular vein; 2: dilated right internal jugular vein; 3: goiter with compression of the right internal jugular vein; 4: thyroid plexus draining into the esophagus varices; 5: inferior thyroid vein; 6: brachiocephalic vein; 7: varices around the esophagus; 8: azygos vein; 9: superior vena cava; Block: Occlusion of the inferior thyroid vein, possibly as a result of previous surgery or recurrent goiter.