scholarly journals Early Recognition and Diagnosis of Buried Bumper Syndrome: A Report of Three Cases

2019 ◽  
Vol 05 (03) ◽  
pp. e76-e81
Author(s):  
Johan Devia ◽  
Juan Jose Santivañez ◽  
Mario Rodríguez ◽  
Sandra Rojas ◽  
Manuel Cadena ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Early Recognition ◽  
Gastric Wall ◽  
Gastrostomy Tube ◽  
Excessive Pressure ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome ◽  
The Moment ◽  
Specific Care ◽  
Gold Standards

AbstractBuried bumper syndrome (BBS) was described as a complication of percutaneous endoscopic gastrostomy (PEG) that occurs when the internal stump of the probe migrates and is located between the gastric wall and the skin. The increase of compression between the internal stump and the external stump of the gastrostomy tube causes pain and the inability to feed. We present the cases of three patients with BBS managed by the metabolic and nutritional support department. These cases intend to illustrate one of the less frequent complications of PEG, clinical presentation, risk factors, diagnosis, and especially clinical management. Although there are no defined gold standards for its management, the most important points in the management of this condition are early recognition, recommendations to avoid ischemic process at the moment of the insertion of the tube, specific care of the gastrostomy tube, and a periodic nutrition evaluation to avoid overweight, which causes traction and excessive pressure in the gastric wall. It is important for physicians to be aware of the recommendations to prevent BBS and its complications, especially in patients in whom communication can be difficult secondary to their pathologies and comorbidities.

scholarly journals General principles for the prevention and treatment of complications of percutaneous endoscopic gastrostomy (review of literature)

2020 ◽  
Vol 26 (3) ◽  
pp. 25-30
Author(s):  
K. V. Golubev ◽  
E. E. Topuzov ◽  
V. V. Oleynik ◽  
T. R. Stuchevskaya ◽  
S. V. Gorchakov
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Preventive Measures ◽  
Gastric Wall ◽  
Postoperative Bleeding ◽  
Gastrostomy Tube ◽  
Review Of Literature ◽  
Endoscopic Gastrostomy ◽  
Abdominal Wall Metastasis ◽  
Buried Bumper Syndrome ◽  
Gastrostomy Complications

We considered the views of researchers presented in the modern literature on both the problem as a whole and discussion questions regarding the causes of development, preventive measures, and methods of treating percutaneous endoscopic gastrostomy complications, such as clogging of the gastrostomy tube, peristomal wound infections, necrotic fasciitis, pneumoperitoneum, buried bumper syndrome, growth of granulations in the gastrostomy zone, postoperative bleeding and intraparietal hematoma of the gastric wall, traumatic dislocation of the gastrostomy tube, peritonitis after percutaneous endoscopic gastrostomy, peristomal leakage, сolonic fistula, liver injury and abdominal wall metastasis at the percutaneous endoscopic gastrostomy site.

scholarly journals Buried Bumper Syndrome Revisited: A Rare but Potentially Fatal Complication of PEG Tube Placement

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Saptarshi Biswas ◽  
Sujana Dontukurthy ◽  
Mathew G. Rosenzweig ◽  
Ravi Kothuru ◽  
Sunil Abrol
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Gastric Wall ◽  
Late Complications ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Delayed Complications ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Percutaneous endoscopic gastrostomy (PEG) has been used for providing enteral access to patients who require long-term enteral nutrition for years. Although generally considered safe, PEG tube placement can be associated with many immediate and delayed complications. Buried bumper syndrome (BBS) is one of the uncommon and late complications of percutaneous endoscopic gastrostomy (PEG) placement. It occurs when the internal bumper of the PEG tube erodes into the gastric wall and lodges itself between the gastric wall and skin. This can lead to a variety of additional complications such as wound infection, peritonitis, and necrotizing fasciitis. We present here a case of buried bumper syndrome which caused extensive necrosis of the anterior abdominal wall.

Liver abscess as a rare complication of PEG

2019 ◽  
Vol 98 (5) ◽  
pp. 219-222
Keyword(s):  
Liver Abscess ◽  
Early Recognition ◽  
Rare Complication ◽  
Oral Intake ◽  
Hepatic Abscess ◽  
Left Liver Lobe ◽  
Pharyngeal Carcinoma ◽  
Endoscopic Gastrostomy ◽  
Close Cooperation ◽  
Buried Bumper Syndrome

Introduction: Percutaneous endoscopic gastrostomy (PEG) is one of the most effective methods of providing long-term enteral nutrition in patients with the impossibility of oral intake. Complications are relatively common. The most common is peristomal wound infection at the site of the insertion and leakage along the cannula. Lesscommon complications are colo-cutaneous fistulas and peritonitis. A very rare complication is liver abscess. Case report: The authors describe a case of a 51-year-old man with a hepatic abscess with inoperable pharyngeal carcinoma with PEG. The patient was admitted to hospital with a developing septic condition due to a liver abscess. The liverabscess resulted from the buried bumper syndrome of the PEG and subsequent complete dislocation of the bumper into the left liver lobe area.. This condition was treated by a surgical review with abscess drainage and the construction of classical gastrostomy. Conclusion: Buried bumper syndrome with its complications, such as a liver abscess is a relatively rare complication, but challenges both the diagnosis and therapy of the syndrome itself. Its management requires a close cooperation between a gastroenterologist and a surgeon. Early recognition and treatment can prevent the progression of the condition to sepsis or a septic shock, which can lead to death.

scholarly journals Buried bumper syndrome – a rare complication of percutaneous endoscopic gastrostomy tube feeding

2012 ◽  
Vol 2 ◽  
pp. 111-113
Author(s):  
Anna Borkowska ◽  
Agnieszka Jankowska ◽  
Agnieszka Szlagatys-Sidorkiewicz ◽  
Piotr Landowski ◽  
Barbara Kamińska
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Rare Complication ◽  
Tube Feeding ◽  
Gastrostomy Tube ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome

Pediatric Buried Bumper Syndrome: Diagnostic Validity of Transabdominal Ultrasound and Artificial Intelligence

2021 ◽  
Author(s):  
Caroline Aguilar ◽  
Adrian P. Regensburger ◽  
Ferdinand Knieling ◽  
Alexandra L. Wagner ◽  
Gregor Siebenlist ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Risk Factors ◽  
Pediatric Patients ◽  
Leukocyte Count ◽  
Gastric Wall ◽  
Diagnostic Value ◽  
Transabdominal Ultrasound ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome ◽  
Us Findings

Abstract Purpose Buried bumper syndrome (BBS) is a severe complication of percutaneous endoscopic gastrostomy (PEG) resulting from overgrowth of gastric mucosa and penetration of the inner holding plate into the gastric wall. The aim of this study was to evaluate the diagnostic value of transabdominal ultrasound (US) in comparison to an artificial intelligence (AI) model for the diagnosis of BBS in children. Materials and Methods In this monocentric retrospective study, pediatric US data concerning BBS from a ten-year period (2009–2019) were analyzed. US findings were compared to a clinical multiparameter-based AI model and reference standard endoscopy. Clinical risk factors for the occurrence of pediatric BBS were determined. Results In n = 121 independent examinations of n = 82 patients, the placement of the inner holding plate of the PEG was assessed by US. In n = 18 cases BBS was confirmed. Recall and precision rates were 100 % for US and 88 % for the AI-based assessment. Risk factors for the occurrence of BBS were mobilization problems of the PEG (rs = 0.66, p < 0.001), secretion/exudation (rs = 0.29, p = 0.002), time between 1st PEG placement and US (rs = 0.38, p < 0.001), and elevated leukocyte count (rs = 0.24, p = 0.016). Conclusion Transabdominal US enables correct, rapid, and noninvasive diagnosis of BBS in pediatric patients. Preceding AI models could aid during diagnostic workup. To avoid unnecessary invasive procedures, US could be considered as a primary diagnostic procedure in suspected BBS. 

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