scholarly journals Buried bumper syndrome: A late complication of PEG tube insertion

2021 ◽  
Vol 9 (10) ◽  
Author(s):  
Norliana Dalila Mohamad Ali ◽  
Bushra Johari ◽  
Yahya Mohd Aripin
Keyword(s):  
Late Complication ◽  
Tube Insertion ◽  
Buried Bumper Syndrome ◽  
Peg Tube

scholarly journals Buried Bumper Syndrome: A Late Complication of PEG Tube Insertion

2021 ◽  
Author(s):  
Norliana Dalila Mohamad Ali ◽  
Bushra Johari ◽  
Yahya Mohd Aripin
Keyword(s):  
Clinical Diagnosis ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Late Complication ◽  
Tube Insertion ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Buried bumper syndrome (BBS) is a rare serious late complication of percutaneous endoscopic gastrostomy (PEG) where the internal bumper migrates along the stoma tract. BBS is a clinical diagnosis and the role of imaging is to identify the exact site of the migrated internal bumper.

scholarly journals The Challenging Buried Bumper Syndrome after Percutaneous Endoscopic Gastrostomy

2016 ◽  
Vol 10 (2) ◽  
pp. 224-232 ◽  
Author(s):  
Ibrahim Afifi ◽  
Ahmad Zarour ◽  
Ammar Al-Hassani ◽  
Ruben Peralta ◽  
Ayman El-Menyar ◽  
...  
Keyword(s):  
Septic Shock ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Rare Complication ◽  
Kidney Injury ◽  
Stomach Wall ◽  
Rapid Progression ◽  
Tube Insertion ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Buried bumper syndrome (BBS) is a rare complication developed after percutaneous endoscopic gastrostomy (PEG). We report a case of a 38-year-old male patient who sustained severe traumatic brain injury that was complicated with early BBS after PEG tube insertion. On admission, bedside PEG was performed, and 7 days later the patient developed signs of sepsis with rapid progression to septic shock and acute kidney injury. Abdominal CT scan revealed no collection or leakage of the contrast, but showed malpositioning of the tube bumper at the edge of the stomach and not inside of it. Diagnostic endoscopy revealed that the bumper was hidden in the posterolateral part of the stomach wall forming a tract inside of it, which confirmed the diagnosis of BBS. The patient underwent laparotomy with a repair of the stomach wall perforation, and the early postoperative course was uneventful. Acute BBS is a rare complication of PEG tube insertion which could be manifested with severe complications such as pressure necrosis, peritonitis and septic shock. Early identification is the mainstay to prevent such complications. Treatment selection is primarily guided by the presenting complications, ranging from simple endoscopic replacement to surgical laparotomy.

A novel device for the endoscopic management of buried bumper syndrome

Endoscopy ◽  
2019 ◽  
Vol 51 (07) ◽  
pp. 689-693 ◽  
Author(s):  
Pieter Hindryckx ◽  
Barbara Dhooghe ◽  
Andreas Wannhoff
Keyword(s):  
Abdominal Pain ◽  
Gastric Mucosa ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Endoscopic Management ◽  
First Line ◽  
Off Label ◽  
Novel Device ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Abstract Background Buried bumper syndrome (BBS) is a complication of percutaneous endoscopic gastrostomy (PEG) in which the internal bumper is overgrown by the gastric mucosa. Apart from loss of patency of the PEG tube, the buried bumper may evoke symptoms such as abdominal pain or peritubular leakage. While the management of an incompletely buried bumper is fairly straightforward, this is not the case for a completely buried bumper. Different approaches to remove completely buried bumpers have been described, including endoscopic knife- or papillotome-based techniques. However, these devices are used off-label and the procedures can be laborious. Methods The Flamingo device has recently been introduced as the first tool specifically designed to remove a completely buried bumper. Results We describe the technique and our first experience in five patients with a completely (n = 4) or almost completely (n = 1) buried bumper. Fast and save removal of the buried bumper was obtained in all patients. Conclusion We believe that this device has the potential to become the standard first-line tool for the management of completely buried bumpers.

CC-011 Case report: colocutaneous fistula – a rare complication of PEG tube insertion

Gut ◽  
2010 ◽  
Vol 59 (Suppl 1) ◽  
pp. A170.1-A170
Author(s):  
A M Verma ◽  
J A D Stewart
Keyword(s):  
Case Report ◽  
Rare Complication ◽  
Tube Insertion ◽  
Colocutaneous Fistula ◽  
Peg Tube

scholarly journals Cutaneous Myiasis Around Gastrostomy (PEG) Tube Insertion Site: The Second Case Report

2019 ◽  
Vol 12 ◽  
pp. 117954761986900
Author(s):  
Mohammed N Bani Hani ◽  
Abdel Rahman Al Manasra ◽  
Hamzeh Daradkah ◽  
Farah Bani Hani ◽  
Zeina Bani Hani
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Insertion Site ◽  
Clinical Form ◽  
Tube Insertion ◽  
Endoscopic Gastrostomy ◽  
Short Period ◽  
Cutaneous Myiasis ◽  
Peg Tube ◽  
Systemic Agents

Background: Myiasis refers to the infestation of live human with 2-winged larvae (maggots). Cutaneous myiasis is the most commonly encountered clinical form. It is divided into 3 main forms: furuncular, creeping (migratory), and wound (traumatic) myiasis. Case report: In this article, we report an extremely rare case of myiasis around percutaneous endoscopic gastrostomy (PEG) tube in a 71-year-old female patient. She had the tube placed for feeding purposes, 8 months prior to her presentation. Family noticed alive worms emerging from skin at the gastrostomy tube insertion site. Patient was treated conservatively with daily dressing with no debridement or use of systemic agents. Conclusions: PEG tube cutaneous myiasis is an extremely rare disease. Conservative management with petroleum-based and sterilizing agents is shown to be efficient to clear the disease in a short period of time.

scholarly journals Comparison of removal techniques in the management of buried bumper syndrome: a retrospective cohort study of 82 patients

2017 ◽  
Vol 05 (07) ◽  
pp. E603-E607 ◽  
Author(s):  
Daniela Mueller-Gerbes ◽  
Bettina Hartmann ◽  
Julio Lima ◽  
Michele de Lemos Bonotto ◽  
Christoph Merbach ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Treatment Success ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Tube Removal ◽  
Tube Dysfunction ◽  
Gastrostomy Tube Placement ◽  
Buried Bumper Syndrome ◽  
Needle Knife ◽  
Peg Tube

Abstract Background and study aims Buried bumper syndrome is an infrequent complication of percutaneous endoscopic gastrostomy (PEG) that can result in tube dysfunction, gastric perforation, bleeding, peritonitis or death. The aim of this study was to compare the efficacy of different PEG tube removal methods in the management of buried bumper syndrome in a large retrospective cohort. Patients and methods From 2002 to 2013, 82 cases of buried bumper syndrome were identified from the databases of two endoscopy referral centers. We evaluated the interval between gastrostomy tube placement and diagnosis of buried bumper syndrome, type of treatment, success rate and complications. Four methods were analyzed: bougie, grasp, needle-knife and minimally invasive push method using a papillotome, which were selected based on the depth of the buried bumper. Results The buried bumper was cut free with a wire-guided papillotome in 35 patients (42.7 %) and with a needle-knife in 22 patients (26.8 %). It could be pushed into the stomach with a dilator without cutting in 10 patients (12.2 %), and was pulled into the stomach with a grasper in 12 patients (14.6 %). No adverse events (AEs) were registered in 70 cases (85.4 %). Bleeding occurred in 7 patients (31.8 %) after cutting with a needle-knife papillotome and in 1 patient (8.3 %) after grasping. No bleeding was recorded after using a standard papillotome or a bougie (P < 0.05). Ten of 22 patients (45.5 %) treated with the needle-knife had a serious AE and 1 patient died (4.5 %). Conclusions We recommend that incomplete buried bumpers be removed with a bougie. In cases of complete buried bumper syndrome, the bumper should be cut with a wire-guided papillotome and pushed into the stomach.

scholarly journals Buried Bumper Syndrome Revisited: A Rare but Potentially Fatal Complication of PEG Tube Placement

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Saptarshi Biswas ◽  
Sujana Dontukurthy ◽  
Mathew G. Rosenzweig ◽  
Ravi Kothuru ◽  
Sunil Abrol
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Gastric Wall ◽  
Late Complications ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Delayed Complications ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Percutaneous endoscopic gastrostomy (PEG) has been used for providing enteral access to patients who require long-term enteral nutrition for years. Although generally considered safe, PEG tube placement can be associated with many immediate and delayed complications. Buried bumper syndrome (BBS) is one of the uncommon and late complications of percutaneous endoscopic gastrostomy (PEG) placement. It occurs when the internal bumper of the PEG tube erodes into the gastric wall and lodges itself between the gastric wall and skin. This can lead to a variety of additional complications such as wound infection, peritonitis, and necrotizing fasciitis. We present here a case of buried bumper syndrome which caused extensive necrosis of the anterior abdominal wall.

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