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.

Cutaneous Amebiasis

PEDIATRICS ◽  
1983 ◽  
Vol 71 (4) ◽  
pp. 595-598
Author(s):  
Mary Ellen Rimsza ◽  
Robert A. Berg
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Wall ◽  
Entamoeba Histolytica ◽  
Liver Abscess ◽  
Rare Complication ◽  
Hepatic Abscess ◽  
Amebic Liver Abscess ◽  
Colostomy Site ◽  
Histolytica Infection ◽  
Laparotomy Incision

An infant with cutaneous amebiasis of the vulva and amebic liver abscess is described. Epidemiologic investigations and serologic studies were crucial in establishing the diagnosis. The vulvar amebic ulcers responded dramatically to metronidazole therapy. Cutaneous amebiasis is a rare complication of Entamoeba histolytica infection which should be considered in the differential diagnosis of perineovulvar or penile ulcers. Cutaneous amebiasis may also occur on the abdominal wall surrounding a draining hepatic abscess, colostomy site, or laparotomy incision.

scholarly journals The Challenging Buried Bumper Syndrome after Percutaneous Endoscopic Gastrostomy

2016 ◽  
Vol 10 (2) ◽  
pp. 224-232 ◽  
Author(s):  
Ibrahim Afifi ◽  
Ahmad Zarour ◽  
Ammar Al-Hassani ◽  
Ruben Peralta ◽  
Ayman El-Menyar ◽  
...  
Keyword(s):  
Septic Shock ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Rare Complication ◽  
Kidney Injury ◽  
Stomach Wall ◽  
Rapid Progression ◽  
Tube Insertion ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Buried bumper syndrome (BBS) is a rare complication developed after percutaneous endoscopic gastrostomy (PEG). We report a case of a 38-year-old male patient who sustained severe traumatic brain injury that was complicated with early BBS after PEG tube insertion. On admission, bedside PEG was performed, and 7 days later the patient developed signs of sepsis with rapid progression to septic shock and acute kidney injury. Abdominal CT scan revealed no collection or leakage of the contrast, but showed malpositioning of the tube bumper at the edge of the stomach and not inside of it. Diagnostic endoscopy revealed that the bumper was hidden in the posterolateral part of the stomach wall forming a tract inside of it, which confirmed the diagnosis of BBS. The patient underwent laparotomy with a repair of the stomach wall perforation, and the early postoperative course was uneventful. Acute BBS is a rare complication of PEG tube insertion which could be manifested with severe complications such as pressure necrosis, peritonitis and septic shock. Early identification is the mainstay to prevent such complications. Treatment selection is primarily guided by the presenting complications, ranging from simple endoscopic replacement to surgical laparotomy.

The Buried Bumper Syndrome - A Rare Complication Following Percutaneous Endoscopic Gastrostomy

Swiss Surgery ◽  
1999 ◽  
Vol 5 (5) ◽  
pp. 243-246 ◽  
Author(s):  
Spalinger ◽  
Schmid ◽  
Bertschinger ◽  
Schöb ◽  
Largiadèr
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Rare Complication ◽  
Endoscopic Gastrostomy ◽  
Sind Eine ◽  
Buried Bumper Syndrome

Das buried bumper-Syndrom ist eine seltene Komplikation nach perkutaner endoskopischer Gastrostomie (PEG). Dabei kommt es zu einer Überwucherung der PEG-Platte mit hypertropher Magenschleimhaut und Einwachsen der Platte in die Magenwand. Dies wird wahrscheinlich durch ein zu straffes Anziehen der PEG-Sonde begünstigt. Endoskopisch ist die Halteplatte nicht mehr sichtbar. Die Symptome des buried bumper-Syndroms sind eine schlecht durchgängige und nicht mobilisierbare PEG-Sonde, Sekretion neben der Sonde und Oberbauchschmerzen. Meistens ist eine endoskopische Entfernung der Platte möglich. Gelingt dies nicht, ist die operative Entfernung der Sonde nötig. Nach endoskopischer Entfernung der Sonde ist eine erneute endoskopische Sondeneinlage möglich.

scholarly journals Management of Fish Bone-Induced Liver Abscess with Foreign Body Left In Situ

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Ryan Burkholder ◽  
Hrishikesh Samant
Keyword(s):  
Foreign Body ◽  
Liver Abscess ◽  
Rare Case ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Fish Bone ◽  
Interesting Case ◽  
Liver Lobe ◽  
Left Liver Lobe

Pyogenic liver abscess, having experienced an evolving pathogenesis over the years, still remains a serious problem with significant morbidity. Iatrogenic and ascending biliary infections are the most common known etiologies for hepatic abscess. Here we report an interesting case of an elderly lady admitted with abdominal pain due to a pyogenic liver abscess in the left liver lobe which was attributed to perforation by an ingested fish bone. The authors also reviewed literature for management for this rare case as there are no standard guidelines. Our patient was successfully treated with antibiotics and percutaneous drainage with foreign body left in situ.

scholarly journals Buried bumper syndrome presenting with bleeding

2018 ◽  
Vol 11 (1) ◽  
pp. e225876 ◽  
Author(s):  
Khaled Bamakhrama ◽  
Tahani Ahmed Aldaham ◽  
Omar Alassaf
Keyword(s):  
Emergency Department ◽  
Physical Examination ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Rare Complication ◽  
Patient Treatment ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Buried bumper syndrome (BBS) is a relatively rare complication of percutaneous endoscopic gastrostomy (PEG) feeding. In this paper, we report the case of a 74-year-old man who attended the emergency department with bleeding from the PEG tube site that was later confirmed by endoscopy to be BBS. The treatment consisted of a PEG tube replacement with a 10-day course of antibiotics. Furthermore, this report discusses possible signs, symptoms and physical examination signs suggesting BBS. It can cause serious complications that might sometimes be fatal. Therefore, the diagnosis needs to be done swiftly and the patient treatment to start without delay. BBS should always top the differentials of physicians once suspected.

Nurse-led service for children with gastrostomies: a 2-year review

2021 ◽  
Vol 30 (8) ◽  
pp. 462-466
Author(s):  
Radhika Patel ◽  
Mohamed Mutalib ◽  
Akhilesh Pradhan ◽  
Hannah Wright ◽  
Manasvi Upadhyaya
Keyword(s):  
Text Message ◽  
Oral Intake ◽  
Exact Test ◽  
Paediatric Hospital ◽  
Endoscopic Gastrostomy ◽  
Future Care ◽  
Buried Bumper Syndrome ◽  
Peg Tube ◽  
Provision Of Care ◽  
The Impact

Background: Percutaneous endoscopic gastrostomy (PEG) feeding can provide long-term nutritional support for patients with a functional gastrointestinal system but insufficient oral intake. Some patients, however, may require jejunal feeding, which can be achieved using a PEG tube with jejunal extension (PEG-J). A previous review at a tertiary paediatric hospital revealed poor documentation and a high incidence of buried bumper syndrome (BBS) in children with gastrostomies. Subsequently, a nurse-led service for gastrostomy care was introduced. Aim: To determine the impact of the nurse-led service. Methods: Prospective review, at 1 year and 2 years, following either a PEG or PEG-J insertion. Patient records were reviewed and a telephone survey was conducted. Statistical analysis was performed using Fisher's exact test. Findings: 32 PEG and 6 PEG-J patients were included in this study. There was 100% documentation of provision of care instructions. Average satisfaction with the service was over 8/10. Incidence of BBS was 0% in the PEG group and 17% in the PEG-J group. Of those parents/carers surveyed, 74% wanted additional tube care support via SMS text message. Conclusion: Introduction of a nurse-led service resulted in complete documentation of provision of care and sustained high levels of parental satisfaction. Future care should focus on utilising technological platforms.

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

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.

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