Fill a large pot with half water and half wine and bring to a boil.

Using your hands, form the sausage into small meatballs, about the size of marbles. In a 12- to 14-inche sauté pan, heat the oil over medium heat, until just smoking. Add the sausage balls in two batches and sauté, rolling them around, until they are browned all over, 5 to 6 minutes per batch. Remove and set aside on a plate.

Add the cauliflower to the pan and cook until soft, about 5 minutes. Add the garlic and the red pepper flakes, cook for another minute, and add the 1 cup red wine to the cauliflower. Bring to a boil, and then add the tomato sauce and sausage balls. Bring to a boil again. Then lower the heat to a simmer and cook for 5 minutes. Remove from the heat.

Drop the garganelli into the boiling wine/water, season heavily with salt, and cook for 1 minute less than the package instructions indicate. Just before the pasta is done, carefully ladle 1/2 cup of the cooking wine/water into the sausage mixture.

Drain the pasta into a colander and add it to the sausage mixture. Toss until pasta is nicely coated. Pour into a serving bowl and serve immediately, with the grated Pecorino on the side.