Colonic varices are a rare subtype of ectopic varices and form due to portal hypertension, splenic or portal vein thrombosis, and mesenteric vein obstruction. When present, they are most common in ...the rectum. We discuss a patient with hematochezia who had isolated right-sided colonic varices related to pancreatic cancer, which is rare. The mass involved the superior mesenteric vein, leading to left-sided portal hypertension and resultant varices. These are difficult to diagnosis because they flatten with insufflation on colonoscopy, so computed tomography or angiography is the gold standard. Treatment options are limited and may require a multidisciplinary approach.
The environmental cost of production-the impacts of effluents such as greenhouse gas (GHG) emissions, air particulates, and water pollutants-on society and the environment is a growing global concern ...for governments, corporations, and consumers. Proposed regulatory schemes seek to address many of these environmental problems by imposing policies to internalize the environmental costs associated with production-such as a tax on the emissions of carbon dioxide, or a carbon tax. But businesses lack a framework that provides a quick and easy way to analyze the effect that changing environmental cost structures may have on corporate business strategy.
