Buried bumper syndrome--complication of percutaneous endoscopic gastrostomy

Percutaneous endoscopic gastrostomy has gained wide acceptance as a relatively safe and efficient means of long-term enteral nutrition support. We describe an elderly patient in whom the internal bumper eroded into the gastric wall and was completely covered by gastric mucosa about 2 months after gastrostomy tube placement. The end orifice of the gastrostomy tube in the stomach lumen was patent, so it functioned well. Needle-type papillotome was applied endoscopically to cut the overlying mucosa, explored the buried bumper and then, reverted the gastrostomy tube in situ. We reviewed the reported methods and recommended this approach for patients with "buried bumper" syndrome to prevent continued tube migration into the gastric wall.