Are PEGJs a Risk Factor for the Buried Bumper Syndrome?

Area of Science:

• Gastroenterology
• Surgical Complications
• Medical Device Safety

Background:

• Percutaneous endoscopic gastrostomies (PEGs) and PEG with jejunal extensions (PEGJs) are common enteral feeding methods.
• Buried bumper syndrome (BBS) is a known complication of these devices.

Purpose of the Study:

• To identify risk factors for BBS.
• To review current management strategies for BBS.
• To determine optimal timing for surgical intervention in BBS cases.

Main Methods:

• Retrospective review of hospital coding and specialist nurse database (2012-2014).
• Inclusion of all patients with BBS and all PEG/PEGJ insertions during the study period.
• Case note review to identify risk factors, management, and outcomes.

Main Results:

• Nine cases of BBS identified among 212 PEGs and 22 PEGJs.
• PEGJ tubes had a significantly higher incidence of BBS (32%) compared to PEG tubes (0.9%).
• One death occurred due to sepsis; other patients required laparotomy for bumper removal.

Conclusions:

• BBS is a serious complication requiring urgent intervention.
• PEGJ tubes are associated with a higher incidence of BBS than PEG tubes.
• Jejunal extensions may complicate routine maintenance, potentially increasing BBS risk.