Early buried bumper syndrome treated by bedside replacement: Report of two cases and review of the literature

Anas Kadah, Tawfik Khoury, Wisam Sbeit

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Background: Buried bumper syndrome (BBS) mostly occurs as a late complication after percutaneous endoscopic gastrostomy (PEG) insertion; however, early BBS has been rarely reported, and the treatment of this condition is still unclear. Objectives: To evaluate the Seldinger technique for treatment of early BBS after PEG insertion. Methods: We report two cases of early BBS in two consecutive patients who underwent PEG insertion to maintain oral intake. The first patient was an 83-year-old woman showing Alzheimer type dementia, while the other was a 76-year-old man who presented with maxillary cancer and treated with radiotherapy followed by left maxillectomy. Post-surgery, he developed progressive difficulty of swallowing due to mouth deformation and treatment-related nerve toxicity. The first patient presented with fever and purulent discharge from the gastrostomy insertion site, without ability to rotate or slide the tube through the stoma 10 days after the PEG insertion. The man was admitted to the hospital 5 days following PEG insertion due to a fever of 38°C and peritubal swelling with purulent discharge. In addition, the tube could not rotate or slide through the stoma. Results: Buried bumper syndrome was demonstrated by computed tomography scan. Gastroscopy and gastrostomy tube replacement was performed successfully according to the Seldinger technique (replacement over guidewire) in both cases. Correct intragastric tube positioning was demonstrated radiographically before resuming tube feeding. The two patients were discharged in good physical condition several days later. Conclusions: External replacement over guide wire should be considered in such cases.

Original languageEnglish
Pages (from-to)315-319
Number of pages5
JournalIsrael Medical Association Journal
Volume22
Issue number5
StatePublished - May 2020

Bibliographical note

Publisher Copyright:
© 2020 Israel Medical Association. All rights reserved.

Keywords

  • Buried bumper syndrome (BBS)
  • Percutaneous endoscopicgastrostomy (PEG)

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