THE ENCOURAGING results of recent operations designed to relieve portal hypertension have brought renewed interest in the nature of varices of the esophagus. It is generally assumed that these lesions, often fatal because of massive bleeding from them, are secondary to increased pressure within the portal system of veins. In the great majority of patients, this is true. Occasionally, however, esophageal varices are found in the absence of portal hypertension, and for these persons operations designed to correct increased portal venous pressure would be ill-advised. The problem is illustrated by a patient recently studied at City Hospital, Cleveland. REPORT OF A CASE J. B., a 42-year-old white man, was admitted to City Hospital on Jan. 15, 1951, because of severe frostbite of both feet following six days of exposure to freezing weather. The patient had been in good health in the past but admitted a poor dietary intake and chronic