Percutaneous endoscopic gastrostomy complicated by buried bumper syndrome.

International surgery

PubMedID: 12872895

Sasaki T, Fukumori D, Sato M, Sakai K, Ohmori H, Yamamoto F. Percutaneous endoscopic gastrostomy complicated by buried bumper syndrome. Int Surg. 2003;88(2):64-7.
We experienced one case of so-called buried bumper syndrome (BBS) in which the bumper at the tip of the gastrostomy tube was buried in the abdominal wall after a percutaneous endoscopic gastrostomy (PEG). A 52-year-old woman had suffered a cerebral hemorrhage, which led her to become bedridden and eventually caused an aggravation of dysphagia, and as a result, the patient received a PEG. On postoperative day 41, the gastrostomy tube became obstructed, making the infusion of nutrients impossible and producing a leakage of nutrients from around the site of insertion. Endoscopy demonstrated that the bumper within the stomach became buried within the submucosa with only the tip of the bumper being partially observed. Abdominal computed tomography (CT) revealed the bumper to be buried in the abdominal wall. Based on these findings, a diagnosis of buried bumper syndrome was established. The gastrostomy tube was thereafter removed percutaneously and successfully replaced by a new tube at the same site. Although BBS is still relatively uncommon, it may be a complication that deserves increasing attention because PEG is expected to be performed more frequently in the future.