The following case demonstrates small bowel varices

without esophago-gastric varices as an unusual cause

of gastrointestinal bleeding in a patient with chronic

liver disease.

The patient is a 47 year-old man who presented to the

hospital with several days of back pain and weakness.

The work-up of his symptoms revealed a L3-L4

phlegmon on MRI of the lumbar spine. A biopsy of this

lesion yielded focal nonviable bone.