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Buried bumper syndrome: old problem, new tricks.

Charles K F Vu1

  • 1Department of General Medicine, Tan Tock Seng Hospital, Singapore. charles_vu@notes.ttsh.gov.sg

Journal of Gastroenterology and Hepatology
|August 31, 2002
PubMed
Summary

Buried bumper syndrome, a complication of percutaneous endoscopic gastrostomy (PEG), can often be resolved with simple external traction. This approach avoids invasive endoscopic or surgical interventions for buried internal bumpers.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Procedures

Background:

  • Buried bumper syndrome is a rare but recognized complication following percutaneous endoscopic gastrostomy (PEG) tube placement.
  • It arises from excessive tension between the internal and external bumpers, leading to the internal bumper embedding into the gastric or abdominal wall.

Observation:

  • Two cases involving buried soft-tip bumpers are presented.
  • Both cases demonstrated successful and uncomplicated removal of the internal bumper using simple external traction.
  • This method obviated the need for surgical, endoscopic, or radiological interventions.

Findings:

  • External traction proved to be an effective and straightforward method for resolving buried bumper syndrome in the reported cases.
  • The original tract's condition influenced the re-insertion site for a new PEG tube, with one case utilizing the same incompletely closed tract and the other an adjacent site.

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Implications:

  • The study highlights a simple, non-invasive technique for managing buried bumper syndrome, potentially reducing healthcare costs and patient morbidity.
  • The development of externally removable internal bumpers may further simplify management and decrease the incidence of this complication.
  • This approach offers a valuable alternative to more invasive procedures for buried internal bumper removal.