The Buried Bumper Syndrome: A Catastrophic Complication of Percutaneous Endoscopic Gastrostomy.

Cureus

Gastroenterology, University of Miami, John F Kennedy Regional Campus, Atlantis, USA.

Published: March 2019

Percutaneous endoscopic gastrostomy (PEG) is a safe and widely used method of providing enteral nutrition in patients unable to tolerate per oral intake. Common complications include gastrointestinal bleeding, dislodgment, perforation, abdominal wall abscess, and aspiration. "Buried bumper syndrome" (BBS) is a rare but potentially fatal complication resulting in malfunction of the tube, gastric perforation, bleeding, and peritonitis. Gastroenterologists should be cognizant of the clinical presentation and treatment of a buried bumper. We report a case of a 56-year-old woman who presented with coffee-ground emesis and was managed with the placement of a gastro-jejunal tube.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538410PMC
http://dx.doi.org/10.7759/cureus.4330DOI Listing

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Article Synopsis
  • The study focuses on the risk factors and complications associated with percutaneous endoscopic gastrostomy (PEG) in elderly patients, emphasizing old age, multimorbidity, and improper PEG placement as major risks.
  • It involved a retrospective analysis of 136 elderly patients who underwent PEG placement between 2017 and 2023, finding that while minor complications were higher than expected, major complications and mortality rates were lower than reported in other studies.
  • The authors conclude that enhancing PEG placement techniques and patient management may help reduce the risks associated with PEG, particularly in older adults.
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Numerous patients stand to gain significant health benefits from enteral nutrition support facilitated by percutaneous feeding tubes. Consequently it is crucial for endoscopists, general practitioners, surgeons and neurologists to be well-versed with indications, contraindications and potential complications of PEG and other enteral feeding tubes. In this context we present a concise overview of the new national guidelines by the Swedish Society of Gastroenterology regarding the management of PEG and other enteral feeding tubes.

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