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[The buried gastrostomy bumper syndrome]
Harefuah
|August 1, 1996
Summary
Buried gastrostomy bumper syndrome, a rare complication of percutaneous endoscopic gastrostomy (PEG), occurs when internal and external bumpers cause mucosal occlusion. This case highlights a difficult removal of an embedded PEG bumper.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Surgical Complications
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a common procedure for enteral feeding.
- Buried gastrostomy bumper syndrome is a rare but serious complication of PEG.
- This syndrome results from the interaction between a rigid internal bumper and gastric mucosal tissue.
Observation:
- A patient developed buried gastrostomy bumper syndrome one year after PEG insertion.
- The PEG bumper became embedded beneath the gastric mucosa, causing complete occlusion.
- Feeding was impossible due to the blocked gastrostomy tract.
Findings:
- The case demonstrates a delayed presentation of buried gastrostomy bumper syndrome.
- Removal of the embedded bumper was challenging.
- A novel technique using a sphincterotome's cutting wire facilitated bumper removal.
Implications:
- Highlights the importance of recognizing and managing buried gastrostomy bumper syndrome.
- Suggests sphincterotome cutting wire as a potential tool for difficult PEG bumper removal.
- Underscores the need for considering soft bumper alternatives despite cost constraints.