scholarly journals The Buried Bumper Syndrome: External Bumper Extraction after Radial Mini Incisions and Replacement through an Adjacent Tract

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
M. A. Benatta
Keyword(s):  
Nutritional Support ◽  
Laparoscopic Treatment ◽  
Abdominal Ct ◽  
Endoscopic Gastrostomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Adjacent Site ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Although considered as a safe method to provide long-term nutritional support, percutaneous endoscopic gastrostomy (PEG) may be complicated by a buried bumper syndrome (BBS), a life-threatening condition. Removal of the PEG tube with its buried bumper and reinsertion of a new PEG tube is often necessary. Since its description in 1988, less than 50 cases of BBS managed by external extraction of the buried bumper have been reported. We report a case of buried bumper that was removed by external traction without the need for endoscopic or laparoscopic treatment but with the need of two radial millimeter skin incisions after abdominal CT study and finally immediate PEG replacement but through an adjacent site.

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.

scholarly journals Management of early PEG tube dislodgement: simultaneous endoscopic closure of gastric wall defect and PEG replacement

2019 ◽  
Vol 12 (9) ◽  
pp. e230728
Author(s):  
Peter Cmorej ◽  
Matthew Mayuiers ◽  
Choichi Sugawa
Keyword(s):  
Enteral Feeding ◽  
Gastric Wall ◽  
Feeding Tube ◽  
Wall Defect ◽  
Endoscopic Gastrostomy ◽  
Endoscopic Closure ◽  
Endoscopic Clips ◽  
Adjacent Site ◽  
Peg Tube

A 53-year-old man with dysphagia underwent uneventful placement of a percutaneous endoscopic gastrostomy (PEG) tube for long-term enteral feeding access. 11 hours after the procedure, it was discovered that he had accidentally dislodged the feeding tube. On physical examination, he was found to have a benign abdomen without evidence of peritonitis or sepsis. He was observed overnight with serial abdominal examinations and nasogastric decompression. In the morning, he was taken back to the endoscopy suite where endoscopic clips were employed to close the gastric wall defect and a PEG tube was replaced at an adjacent site. The patient was fed 24 hours thereafter and discharged from the hospital 48 hours after the procedure. Early accidental removal of a PEG tube in patients without sepsis or peritonitis can be safely treated with simultaneous endoscopic closure of the gastrotomy and PEG tube replacement, resulting in earlier enteral feeding and shorter hospital stay.

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.

scholarly journals Long-Term Survival of Patients Receiving Artificial Nutrition in Japanese Psychiatric Hospitals

2016 ◽  
Vol 6 (3) ◽  
pp. 477-485 ◽  
Author(s):  
Keiichi Abe ◽  
Ryuko Yamashita ◽  
Keiko Kondo ◽  
Keiko Takayama ◽  
Osamu Yokota ◽  
...  
Keyword(s):  
Multiple Logistic Regression Analysis ◽  
Tube Feeding ◽  
Oral Intake ◽  
Psychiatric Hospitals ◽  
Artificial Nutrition ◽  
Term Survival ◽  
Long Term Survival ◽  
Endoscopic Gastrostomy ◽  
Peg Tube

Background/Aims: Most patients with dementia suffer from dysphagia in the terminal stage of the disease. In Japan, most elderly patients with dysphagia receive either tube feeding or total parenteral nutrition. Methods: In this study, we investigated the factors determining longer survival with artificial nutrition. Various clinical characteristics of 168 inpatients receiving artificial nutrition without oral intake in psychiatric hospitals in Okayama Prefecture, Japan, were evaluated. Results: Multiple logistic regression analysis showed that the duration of artificial nutrition was associated with a percutaneous endoscopic gastrostomy (PEG) tube, diagnosis of mental disorder, low MMSE score, and absence of decubitus. Conclusion: Patients with mental disorders survived longer than those with dementia diseases on artificial nutrition. A PEG tube and good nutrition seem to be important for long-term survival.

scholarly journals Considerations for Continuing Semielective and Emergency Otolaryngological Procedures During the COVID-19 Pandemic

2020 ◽  
Vol 100 (1) ◽  
pp. 19-25
Author(s):  
Sarina K. Mueller ◽  
Maximilian Traxdorf ◽  
Konstantinos Mantsopoulos ◽  
Antoniu-Oreste Gostian ◽  
Matti Sievert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Emergency Surgery ◽  
Transmission Rate ◽  
Medical Personnel ◽  
Human Beings ◽  
Threatening Condition ◽  
Long Time ◽  
Life Threatening

Introduction: During the COVID-19 pandemic, worldwide over 600,000 human beings died due to the cause of the disease. In order to deescalate the transmission rate and to avoid crush loading the countries medical health systems social distancing, face masks, and lockdowns have been considered essential by the majority of governments. Whereas some countries have highly reduced or completely stopped otorhinolaryngological procedures, other countries have continued selected surgeries. The objective of this study was to analyze procedures and outcomes of continuing semielective and emergency surgeries during the COVID-19 pandemic. Methods: Retrospective analysis of n = 750 patients who received semi-elective or emergency surgery between March 26 and June 16, 2020, in the Otolaryngology Department of the Friedrich-Alexander-University of Erlangen-Nürnberg. All patients were screened for COVID symptoms and swabbed for SARS-CoV-2 prior to surgery. Results: Of the n = 750 patients, n = 699 patients received semielective surgery and n = 51 emergency surgery. For 27 patients, the swab result could not be awaited due to a life-threatening condition. In these cases, surgery was performed in full protective equipment. No patient was tested positive during or after the surgery (follow-up 45 to 127 days). No member of the medical personnel showed symptoms or was tested positive after contact with patients. Due to the continuation of surgeries, patients’ lives were saved and improvement of long-term quality-of-life and outcomes is anticipated. Conclusions: Continuing selected otorhinolaryngological surgeries is crucial for patients’ health, survival, and long-time quality of life, yet, the protection of the medical personnel has to be granted.

The Buried Bumper Syndrome As a Long-Term Complication of Percutaneous Endoscopic Gastrostomy (PEG): Management in a Tertiary Care Center

2005 ◽  
Vol 61 (5) ◽  
pp. AB161 ◽  
Author(s):  
Maximilian Bittinger ◽  
Werner Schmidbaur ◽  
Reinhard Fleischmann ◽  
Andreas Probst ◽  
Thomas Eberl ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome

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.

scholarly journals Laparoscopic Treatment of a Rare Right Diaphragmatic Rupture with Small Bowel Herniation after Blunt Thoracic Trauma

2010 ◽  
Vol 2010 ◽  
pp. 1-2 ◽  
Author(s):  
H. Hoffmann ◽  
D. Oertli ◽  
O. Heizmann
Keyword(s):  
Small Bowel ◽  
Laparoscopic Approach ◽  
Diaphragmatic Rupture ◽  
Laparoscopic Treatment ◽  
Diaphragm Rupture ◽  
Traumatic Diaphragmatic Rupture ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Right ◽  
Delay Of Diagnosis

Blunt traumatic diaphragmatic rupture (BTDR) is a life-threatening condition with an incidence from 0,8%–1,6% in blunt trauma, mostly located on the left side. The main prognostic factors are severe side injuries and the delay of diagnosis. We present a rare case of a 68-year-old female, with an isolated right diaphragm rupture. The diagnosis was done with a delay of 4 days by thoracic radiographs, which showed a herniation of small bowel into the right thoracic cavity. A reposition of the small bowel and a closure of the diaphragmatic defect by running suture were carried out laparoscopicly. Although large prospective studies concerning the outcome of laparoscopic approach to right BTDR are still missing, we could show, that laparoscopy can be performed safely in right traumatic diaphragm rupture.

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 Duodenal Pressure Necrosis in a Child Caused by a Migrated Percutaneous Endoscopic Gastrostomy

2020 ◽  
Vol 63 (2) ◽  
pp. 79-81
Author(s):  
Jan Melek ◽  
Markéta Štanclová ◽  
Radek Štichhauer ◽  
Pavel Rozsíval ◽  
Jan Kopřiva ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Food Refusal ◽  
Invasive Procedures ◽  
X Ray ◽  
Endoscopic Gastrostomy ◽  
Tertiary Centre ◽  
Pressure Necrosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Centre Hospital

A two-year-old girl with two weeks of abdominal pain, vomiting, and food refusal, ten months after percutaneous endoscopic gastrostomy insertion because of inadequate peroral intake, was admitted to a tertiary centre hospital. On admission, the extracorporeal part of the gastrostomy was much shortened. X-ray examination revealed migration of the end of the gastrostomy tube with a left-shifted course of the tube through the duodenum. Gastroscopy and subsequently laparotomy were performed. A longitudinal pressure necrosis was identified under the tube, with two perforations in the duodenojejunal region. Ten centimeters of that duodenojejunal region were resected, and end-to-end anastomosis was made. The migration of the gastrostomy was probably caused by insufficient care by the parents. Pathophysiologically, the tube caused the pressure necrosis in the duodenojejunal area; this was supported by histology. This is a hitherto undescribed complication of a percutaneous endoscopic gastrostomy, showing that migration of the gastrostomy to the deeper part of the small bowel can lead to pressure necrosis, a potentially life-threatening condition in children which cannot be treated without invasive procedures.

Sign in / Sign up

Export Citation Format

Share Document