Related Experiment Video
Updated: Jun 27, 2026
Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024
The push-pull T technique: an easy and safe procedure in children with the buried bumper syndrome
Raoul I Furlano1, Marc Sidler, Horst Haack
1Pediatric Gastroenterology, University Children's Hospital, Roemergasse 8, 4005 Basel, Switzerland.
Insights
Buried bumper syndrome is a rare but serious complication of percutaneous endoscopic gastrostomy (PEG) tubes in children. This study details a case, removal technique, and prevention strategies for this long-term PEG complication.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
- Surgical Complications
Background:
- Percutaneous endoscopic gastrostomy (PEG) is crucial for nutritional support in pediatric patients unable to feed orally.
- While generally safe, long-term complications can arise, impacting device function and patient care.
- Buried bumper syndrome (BBS) is a recognized, though infrequently reported, complication of PEG tubes.
Observation:
- Gastric mucosa overgrowth onto the internal PEG bumper causes mechanical failure of the feeding tube.
- Published pediatric cases of buried bumper syndrome are notably scarce in medical literature.
- One instance of buried bumper syndrome was observed in a cohort of 76 PEG placements between 2001 and 2008.
Findings:
- The study reports on a single pediatric case of buried bumper syndrome following PEG tube placement.
- An adapted, safe endoscopic technique for the removal of the impacted PEG tube was successfully employed.
- Key recommendations for the prevention of buried bumper syndrome are presented based on clinical experience.
Implications:
- This case highlights the importance of recognizing and managing buried bumper syndrome in pediatric PEG patients.
- The described endoscopic removal technique offers a potentially safer alternative for addressing this complication.
- Implementing the proposed preventive measures may reduce the incidence of buried bumper syndrome in pediatric populations.
Abstract:
Percutaneous endoscopic gastrostomy (PEG) tube placement is a well-established procedure in adults as well as in pediatric patients who cannot be orally fed. However, potential serious complications may occur. The buried bumper syndrome is a well-recognized long-term complication of PEG. Overgrowth of gastric mucosa over the inner bumper of the tube will cause mechanical failure of formula delivery, rendering the tube useless. However, published experience in children with buried bumper syndrome is very scarce. In the authors' clinic, 76 PEG tubes were placed from 2001 to 2008, and buried bumper syndrome occurred in 1 patient. The authors report on their experience with buried bumper syndrome, an adapted safe endoscopic removal technique, as well as recommendations for prevention of buried bumper syndrome.
