Tags

Type your tag names separated by a space and hit enter

A new endoscopic technique for the buried bumper syndrome.
Surg Endosc. 2007 Sep; 21(9):1671-3.SE

Abstract

BACKGROUND

The Buried Bumper Syndrome is a well-recognized long-term complication of percutaneous endoscopic gastrostomy (PEG). Overgrowth of gastric mucosa over the inner bumper of the tube will cause mechanical failure of feed delivery, rendering the tube useless. Endoscopic removal is usually attempted but fails in most cases. Therefore, most of the buried inner bumpers are removed by making an external incision over the PEG site under local anaesthesia or at laparotomy. These approaches can be associated with pain, wound infection, or a gastrocutaneous fistula.

TECHNIQUE

A new method to facilitate the removal of a PEG tube, where the inner bumper is buried in the gastric mucosa, is described. A length of ureteric catheter, or similar tube, is passed through the shortened external PEG tube into the gastric cavity and is then tied to the tube above the skin. The intragastric part of that tube helps to identify the site of the buried bumper and is then trapped within an endoscopic snare. Traction is then applied to the snare, inverting the tube and dislodging the bumper with minimum disruption to the stomach wall. This avoids the need for repair and allows for immediate reinsertion of a fresh PEG tube.

CONCLUSIONS

A PEG tube in a patient with buried bumper syndrome can be safely removed endoscopically, without a skin incision or gastric wall disruption. A novel, simple, and safe endoscopic removal technique is described.

Links

Aggregator Full Text

Authors+Show Affiliations

Leung E
Department of Surgery, Monklands Hospital, Monkscourt Avenue, Airdrie, Lanarkshire, ML6 0LS, United Kingdom.
Chung L
No affiliation info available
Hamouda A
No affiliation info available
Nassar AH
No affiliation info available

MeSH

Device RemovalEndoscopy, GastrointestinalEnteral NutritionGastrostomyHumansIntubation, Gastrointestinal

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17762960

Citation

Leung, E, et al. "A New Endoscopic Technique for the Buried Bumper Syndrome." Surgical Endoscopy, vol. 21, no. 9, 2007, pp. 1671-3.
Leung E, Chung L, Hamouda A, et al. A new endoscopic technique for the buried bumper syndrome. Surg Endosc. 2007;21(9):1671-3.
Leung, E., Chung, L., Hamouda, A., & Nassar, A. H. (2007). A new endoscopic technique for the buried bumper syndrome. Surgical Endoscopy, 21(9), 1671-3.
Leung E, et al. A New Endoscopic Technique for the Buried Bumper Syndrome. Surg Endosc. 2007;21(9):1671-3. PubMed PMID: 17762960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A new endoscopic technique for the buried bumper syndrome. AU - Leung,E, AU - Chung,L, AU - Hamouda,A, AU - Nassar,A H M, Y1 - 2007/02/16/ PY - 2006/04/16/received PY - 2006/11/30/accepted PY - 2007/9/1/pubmed PY - 2007/9/26/medline PY - 2007/9/1/entrez SP - 1671 EP - 3 JF - Surgical endoscopy JO - Surg Endosc VL - 21 IS - 9 N2 - BACKGROUND: The Buried Bumper Syndrome is a well-recognized long-term complication of percutaneous endoscopic gastrostomy (PEG). Overgrowth of gastric mucosa over the inner bumper of the tube will cause mechanical failure of feed delivery, rendering the tube useless. Endoscopic removal is usually attempted but fails in most cases. Therefore, most of the buried inner bumpers are removed by making an external incision over the PEG site under local anaesthesia or at laparotomy. These approaches can be associated with pain, wound infection, or a gastrocutaneous fistula. TECHNIQUE: A new method to facilitate the removal of a PEG tube, where the inner bumper is buried in the gastric mucosa, is described. A length of ureteric catheter, or similar tube, is passed through the shortened external PEG tube into the gastric cavity and is then tied to the tube above the skin. The intragastric part of that tube helps to identify the site of the buried bumper and is then trapped within an endoscopic snare. Traction is then applied to the snare, inverting the tube and dislodging the bumper with minimum disruption to the stomach wall. This avoids the need for repair and allows for immediate reinsertion of a fresh PEG tube. CONCLUSIONS: A PEG tube in a patient with buried bumper syndrome can be safely removed endoscopically, without a skin incision or gastric wall disruption. A novel, simple, and safe endoscopic removal technique is described. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/17762960/A_new_endoscopic_technique_for_the_buried_bumper_syndrome_ L2 - https://doi.org/10.1007/s00464-007-9224-x DB - PRIME DP - Unbound Medicine ER -