フクブ ショクドウ チョウフクショウ ニ タイシ フククウキョウカ テキシュツジュツ オ シコウ シタ １レイ

A 9-year-old boy was admitted to the hospital for close exploration of cystic tumor of the esophagus ventral detected in the abdominal contrast CT scan during the investigation of hematuria. Upper gastrointestinal fluoroscopic and endoscopic examination with ultrasonography showed a cystic tumor with the diameter of 2cm and smooth surface in the abdominal esophagus. Laparoscopic surgery was performed under the diagnosis of abdominal esophageal duplication cyst. At surgery, the soft and well-defined mass was present in the abdominal esophagus ventral and continuous with the esophagus wall. Histopathological study showed the cystic wall was lined with the pseudostratified ciliated epithelium and subepithelial muscle layer. These findings indicated abdominal esophageal duplication cyst. He was discharged on postoperative day 8 with good postoperative course. Abdominal esophageal duplication cyst is a rare disease. Laparoscopic surgery, which has not seen attempted before this case, seems to be a useful treatment of abdominal esophageal duplication cyst

ショウニ ノ タンカン カクチョウガタ スイ タンカン ゴウリュウ イジョウ セツジョレイ ニ ハツガン カンレン イデンシ HDAC ガ コウハツゲン シテイタ 1レイ

Pancreaticobiliary maljunction（PBM）is the congenital malformation that the junction of the pancreatic and bile ducts is located outside of the duodenal wall anatomically, so sphincter function preventing to mix the bile and pancreatic juice does not act. In PBM, the mutual reflux of bile and pancreatic juice induces various diseases and becomes the cause of biliary tract cancer generation. PBM is divided into PBM with the biliary dilatation and PBM without the biliary dilatation. From the perspective of carcinogenesis, surgery to separate the pancreatic juice and bile by excision of extrahepatic biliary tract and hepaticojejunostomy is commonly performed in the former, the treatment of the latter is controversial, for instance ; the only cholecystectomy should be performed and excision of extrahepatic biliary tract is unnecessary or excision of extrahepatic biliary tract and hepaticojejunostomy should be done. In addition, histone acetylation and histone deacetylation is one of the important regulatory mechanism of gene transcription, the error of the balance between histone acetyltransferase（HAT）and histone deacetylase（HDAC）leads to carcinogenesis. In other words, HDAC has a carcinogenic potential. Overexpression of HDAC was found in the both resected gallbladder and bile duct mucosa of infant PBM patient with the biliary dilatation performed the excision of extrahepatic biliary tract and hepaticojejunostomy in our department. Appropriate treatment for PBM has not been established yet, but even infant case with PBM has carcinogenesis potential just like this case. In conclusion, further accumulation of cases including PBM without the biliary dilatation was thought to be essential though the excision of extrahepatic biliary tract and hepaticojejunostomy still seems to be required for infant PBM patient with the biliary dilatation