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Buried bumper syndrome: cut and leave it alone!
Nutr Clin Pract. 2008 Jun-Jul; 23(3):322-4.NC

Abstract

Buried bumper syndrome (BBS) occurs due to the overgrowth of gastric mucosa over the inner bumper of a gastrostomy tube. Various therapeutic approaches have been described for the management of BBS. However, no standardized clinical protocol deals with this complication. The authors describe their experience of dealing with BBS. Case notes of the patients undergoing percutaneous endoscopic gastrostomy (PEG) between February 2002 and December 2007 at their institute were reviewed retrospectively, and cases of BBS were analyzed. During this 71-month period, 356 PEG procedures were preformed. Seven patients with BBS were identified from the case note review (incidence of 1.97%). Attempts at endoscopic removal of the buried bumper were made but unfortunately failed. In view of the patients' associated comorbidity, the buried bumpers in these patients were left in situ, and a new PEG was inserted adjacent to the first site in 6 individuals. In 1 patient, a jejunal extension tube was inserted through the original PEG tube for feeding. No complications from the buried bumper arose in these patients during a median follow-up of 18 months (range, 1-46 months). Some patients being fed by a PEG tube are in poor general health and have significant comorbidities. They are therefore poor candidates for surgical or endoscopic removal of a buried bumper. In such patients, leaving the internal bumper in situ should be considered as a relatively safe treatment option.

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Authors+Show Affiliations

Kejariwal D
Department of Medicine and Gastroenterology, Ipswich Hospital NHS Trust, Ipswich, UK. d_kejariwal@yahoo.com
Aravinthan A
No affiliation info available
Bromley D
No affiliation info available
Miao Y
No affiliation info available

MeSH

AdolescentAdultAgedAged, 80 and overDevice RemovalEndoscopy, GastrointestinalFemaleForeign BodiesGastrostomyHumansIntubation, GastrointestinalMaleRetrospective StudiesTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18595866

Citation

Kejariwal, Deepak, et al. "Buried Bumper Syndrome: Cut and Leave It Alone!" Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 23, no. 3, 2008, pp. 322-4.
Kejariwal D, Aravinthan A, Bromley D, et al. Buried bumper syndrome: cut and leave it alone! Nutr Clin Pract. 2008;23(3):322-4.
Kejariwal, D., Aravinthan, A., Bromley, D., & Miao, Y. (2008). Buried bumper syndrome: cut and leave it alone! Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 23(3), 322-4. https://doi.org/10.1177/0884533608318673
Kejariwal D, et al. Buried Bumper Syndrome: Cut and Leave It Alone. Nutr Clin Pract. 2008 Jun-Jul;23(3):322-4. PubMed PMID: 18595866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Buried bumper syndrome: cut and leave it alone! AU - Kejariwal,Deepak, AU - Aravinthan,A, AU - Bromley,Dawn, AU - Miao,Y, PY - 2008/7/4/pubmed PY - 2008/10/10/medline PY - 2008/7/4/entrez SP - 322 EP - 4 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 23 IS - 3 N2 - Buried bumper syndrome (BBS) occurs due to the overgrowth of gastric mucosa over the inner bumper of a gastrostomy tube. Various therapeutic approaches have been described for the management of BBS. However, no standardized clinical protocol deals with this complication. The authors describe their experience of dealing with BBS. Case notes of the patients undergoing percutaneous endoscopic gastrostomy (PEG) between February 2002 and December 2007 at their institute were reviewed retrospectively, and cases of BBS were analyzed. During this 71-month period, 356 PEG procedures were preformed. Seven patients with BBS were identified from the case note review (incidence of 1.97%). Attempts at endoscopic removal of the buried bumper were made but unfortunately failed. In view of the patients' associated comorbidity, the buried bumpers in these patients were left in situ, and a new PEG was inserted adjacent to the first site in 6 individuals. In 1 patient, a jejunal extension tube was inserted through the original PEG tube for feeding. No complications from the buried bumper arose in these patients during a median follow-up of 18 months (range, 1-46 months). Some patients being fed by a PEG tube are in poor general health and have significant comorbidities. They are therefore poor candidates for surgical or endoscopic removal of a buried bumper. In such patients, leaving the internal bumper in situ should be considered as a relatively safe treatment option. SN - 0884-5336 UR - https://www.unboundmedicine.com/medline/citation/18595866/Buried_bumper_syndrome:_cut_and_leave_it_alone L2 - https://doi.org/10.1177/0884533608318673 DB - PRIME DP - Unbound Medicine ER -