Another approach to the buried bumper syndrome

Frascio, F.; Giacosa, Attilio; Piero, P; Sukkar, Samir Giuseppe; Pugliese, V.; Munizzi, Francesco

doi:10.1016/s0016-5107(96)70334-6

Cited by 26 publications

(20 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6,7 The syndrome usually becomes apparent after 4 months of use. 1,8,9 However, Frascio et al 10 reported an interval of as long as 7 years. In the present patient, the interval between the insertion of the tube and the occurrence of this complication was 2 months.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, over the past few years, treatment methods have also been refined. Frascio et al 10 initially tried the "needle-knife" technique in a patient with buried bumper syndrome. Because they were unsuccessful, they introduced a guidewire into the stomach through the tube and reached the internal bumper via a skin incision made under local anesthesia, then removed the tube totally without opening the peritoneum.…”

Section: Discussionmentioning

confidence: 99%

“…13 In the case of a deep impaction or a migration to the abdominal wall, bleeding, ulceration, or perforation may develop. 10,11 Minimally invasive surgery without opening the peritoneum is an effective and safe method in the management of this complication in such cases.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The buried bumper syndrome: migration of internal bumper of percutaneous endoscopic gastrostomy tube into the abdominal wall

Gençosmanoğlu

Koç

Tözün

2003

Journal of Gastroenterology

View full text Add to dashboard Cite

A percutaneous endoscopic gastrostomy tube was inserted in a 59-year-old man who was undergoing craniotomy due to subarachnoid hemorrhage, because it was estimated that he could not have oral intake for a period of 4 weeks. Seventy days after the insertion, the percutaneous endoscopic gastrostomy tube was replaced because of its accidental removal by the patient. Two months after the second insertion, the tube had to be replaced due to nonfunctioning. The buried bumper syndrome was diagnosed on physical examination, and was confirmed by endoscopy, with findings of mucosal dimpling and nonvisualization of the internal bumper. The tube was removed by external traction without any abdominal incision, and the same site was used for the insertion of a replacement tube over a guidewire. The patient remained symptom-free during 18 months of follow-up.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The buried bumper syndrome: migration of internal bumper of percutaneous endoscopic gastrostomy tube into the abdominal wall

Gençosmanoğlu

Koç

Tözün

2003

Journal of Gastroenterology

View full text Add to dashboard Cite

show abstract

“…The syndrome becomes apparent after 4 months of use, but time intervals as short as 6 days or as long as 7 years have been reported in the literature. 9,10 In some patients, epithelialization with coverage of the internal gastrostomy stoma with gastric mucosa can result in complete closure of the orifice. The burial level of the internal bumper and the stage of mucosal covering over the tube determine symptoms such as immobilization of PEG tube, inability to infuse feeding solutions through the tube, leak around the tube and abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

Acute Buried Bumper Syndrome with Gastric Perforation and Peritonitis: A Rare Complication of Percutaneous Endoscopic Gastrostomy: Case Report

Akarsu¹,

Kantar²

2012

Turkiye Klinikleri J Med Sci

View full text Add to dashboard Cite

ercutaneous endoscopic gastrostomy (PEG) is a broadly accepted procedure of enteral feeding for patients with inadequate oral intake. The side effects and complications of PEG are becoming more evident with its increasing use. Buried bumper syndrome (BBS) is one of the rare complications of PEG and occurs when internal bumper of the PEG tube becomes lodged anywhere between the gastric wall and the skin along the PEG tract. It is considered to be a late complication and becomes apparent months to years after PEG placement.1 Here, we report an unusual case of BBS with a gastric perforation at the internal gastrostomy site and peritonitis that occurred on the third day of placement. The contributing factors, preventive measures and treatment recommendations are also reviewed briefly. A AB BS ST TR RA AC CT T Percutaneous endoscopic gastrostomy (PEG) is a broadly accepted procedure of enteral feeding for patients with inadequate oral intake. The side effects and complications of PEG are becoming more evident with its increasing use. Here, we report a case of buried bumper syndrome, gastric perforation and peritonitis after PEG. In our case, perforated area was closed endoscopically by using hemoclips. The patient was treated with intravenous broad spectrum antibiotics for 10 days and fed by parenteral nutrition. The patient responded well to medical treatment therefore there was not any need for a surgical exploration. Follow up endoscopy was performed 15 days later which showed closure of the perforation area. A new PEG tube was inserted 1 month later.K Ke ey y W Wo or rd ds s: : Peritonitis; endoscopy, gastrointestinal Ö ÖZ ZE ET T Perkütan endoskopik gastrostomi (PEG) ağızdan gıda alımı yetersiz olan hastalarda geniş kabul görmüş bir işlemdir. Artan kullanımla birlikte PEG'in yan etkileri ve komplikasyonları da daha belirgin hale gelmektedir. Burada PEG'den sonra gelişen gömülmüş tampon sendromu, mide perforasyonu ve peritonit olgusunu sunuyoruz. Olgumuzda perfore alan hemoklipler kullanarak endoskopik olarak kapatıldı. Hasta 10 gün boyunca intravenöz geniş spektrumlu antibiyotiklerle tedavi edildi ve parenteral beslendi. Hasta medikal tedaviye iyi yanıt verdi, böylece cerrahi eksplorasyona gerek kalmadı. Onbeş gün sonra takip endoskopisi yapıldı ve perforasyon alanının kapandığı görüldü. Bir ay sonra yeni bir PEG tüpü yerleştirildi.A An na ah ht ta ar r K Ke el li im me el le er r: : Peritonit; endoskopi, gastrointestinal T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J M Me ed d S Sc ci i 2 20 01 12 2; ;3 32 2( (6 6) ): :1 17 79 91 1--5 5

show abstract

“…Recently, it was proposed that the appropriate treatment depends on determining the position of the buried bumper within the layers of the gastric and abdominal walls, using an ultrasound catheter probe [4]. One of the surgical methods described [7] involves making an external incision around the PEG exit site, tracing the tube until the inner bumper is exposed. Others have suggested using radiological guidance to dilate the tract through which the buried bumper can pass externally [5].…”

Section: Discussionmentioning

confidence: 99%