A Rare Complication of Percutaneous Endoscopic Gastrostomy Tube Placement: Early Buried Bumper Syndrome (BBS)

Yasrab Ismail^1,2*, Sanobar Bughio^1
1Consultant Radiologist, Dr Ziauddin Hospital, Karachi, Pakistan.
²Consultant Radiologist Craigavon Area Hospital, Northern Ireland, United Kingdom.

Correspondence to: Yasrab Ismail, Consultant Radiologist, Dr Ziauddin Hospital, Karachi, Pakistan.
Received date: February 16, 2024; Accepted date: March 07, 2024; Published date: March 14, 2024
Citation: Ismail Y, Bughio S. A Rare Complication of Percutaneous Endoscopic Gastrostomy Tube Placement: Early Buried Bumper Syndrome (BBS). J Med Res Surg. 2024;5(1):22-24. doi: 10.52916/jmrs244131
Copyright: ©2024 Ismail Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract

Early Buried Bumper Syndrome (BBS) is a rare complication of Percutaneous Endoscopic Gastrostomy (PEG) tube placement where the internal bolster gets “buried” in the gastrocutaneous fistulous tract. BBS is usually a late complication. We present a case of early BBS, in Radiology Department of Dr Ziauddin Hospital, Karachi. Patient presented with fever and oozing from the side of PEG tube. CT scan abdomen findings revealed, the bumper of the percutaneous endoscopic gastrostomy tube retracted in subcutaneous fat just adjacent to the gastric wall and seen in the left sided rectus sheath outside the gastric lumen. Contrast was given through the peg during the procedure which show no extravasation of contrast in adjacent soft tissues. These findings consistent with early buried bumper syndrome.

Keywords:

Buried Bumper Syndrome (BBS), Percutaneous Endoscopic Gastrostomy (PEG, Esophagus cancer, CT scan, Gastrointestinal.

Conflict of Interest

The authors of the paper you are referring to have declared no conflicts of interest or financial gain.

Funding

No.

References

1. Gauderer WL, Ponsky JL, Izant Jr RJ. Gastrostomywithout laparotomy: a percutaneous endoscopic technique. J Pediatr Surg. 1980;15(6):872-875.
2. Itkin M, DeLegge MH, Fang JC, et al. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, withendorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Gastroenterology. 2011;141(2):742-765.
3. Elbaz T, Rejchrt S, Douda T, et al. Buried bumper syndrome: an uncommon complication of percutaneous gastrostomy.Report of three cases. Folia Gastroenterol Hepatol. 2006;4(2):61–66.
4. Pop GH. Buried bumper syndrome: can we prevent it? Pract Gastroenterol. 2010;34(5):8-13.
5. Lynch CR, Fang JC. Prevention and management of complications of Percutaneous Endoscopic Gastrostomy (PEG) tubes. Pract Gastroenterol. 2004;28(11):66-77.
6. Neeff M, Crowder VL, McIvor NP, et al. Comparison of the use of endoscopic and radiologic gastrostomy in a sin-gle head and neck cancer unit. ANZ J Surg. 2003;73:590-593.
7. Rahnemai-Azar AA, Rahnemaiazar AA, Naghshizadian R, et al. Percutaneous endoscopic gastrostomy: indications, technique, complications and management. World J Gastroenterol. 2014;20(24):7739.
8. Geer W, Jeanmonod R. Early presentation of buried bumper syndrome. West J Emerg Med. 2013;14(5):421-423.
9. Cyrany J, Rejchrt S, Kopacova M, et al. Buried bumper syndrome: a complication of percutaneous endoscopic gastrostomy. World J Gastroenterol. 2016;22(2):618.