[The "buried bumper syndrome"--a rare complication of percutaneous endoscopic gastrostomy]

The buried bumper syndrome is a rare complication of percutaneous endoscopic gastrostomy (PEG). Hereby the PEG bumper is overgrown by hypertrophic gastric mucosa and embedded into the gastric wall. This is probably a consequence of enforced tightening of the PEG tube causing an ulcer in the gastric mucosa. Endoscopically the bumper is not visible anymore. The symptoms of the buried bumper-syndrome are a poorly transporting PEG tube, a PEG tube that cannot be mobilised, secretion along the tube and upper abdominal pain. Most often an endoscopic approach to remove the bumper is successful. If not, the operative removal of the plate is necessary. After endoscopic removal of the tube an endoscopic replacement of a PEG tube is technically possible.