管状型食道重複症の1例

Tubular-type Duplication of the Esophagus, Report of a Case

要旨　消化管重複症の中でもまれな管状型の食道重複症を経験したので報告する．患者は51歳，男性．肝硬変および糖尿病にて外来通院中に嚥下時の咽頭牽引感を訴えたため，食道造影および内視鏡検査を施行した．食道造影検査で，上部食道，下部食道，更にEG junctionにて相互に交通した，2本の管腔構造を認めた．内視鏡検査では，同様の所見が得られ，副食道と思われる管状構造においては更に2か所の隔壁を認めた．内視鏡直視下の粘膜は，2本の管腔構造とも正常食道と変わりなく，ルゴール染色にても同様に染まり，生検にても両者とも重層扁平上皮を示した．以上より管状型の食道重複症と診断した．

　Duplication of the digestive tract, especially the tubular-type duplication of the esophagus, is rare. This paper describes a recent case of this anomaly.

　A 51 year-old man, who was undergoing treatment for liver cirrhosis and diabetes mellitus at the outpatient department of our hospital, complained of a feeling of traction in the pharynx while swallowing. Esophagography showed the presence of two tubular structures, which communicated with each other at the proximal and distal part of the esophagus and E-G junction. Furthermore, endoscopy revealed that two more septa were present in a tubular structure which seemed to be a pseudo-esophagus, and that the mucosa covering the two tubular structures had the same appearance and could be stained with Lugol's solution in the same way as the normal esophageal mucosa. Biopsy showed that the mucosa of the two tubular structures consisted of stratified squamous epithelia. These findings led us to a diagnosis of the tubular-type duplication of the esophagus.