• Tzong-Hsi Lee and Jaw-Town Lin.
• Division of Gastroenterology, Departments of Internal Medicine, Far Eastern Memorial Hospital, National Taiwan University Hospital, Taipei, Taiwan.
• Gastrointest. Endosc. 2008 Sep 1; 68 (3): 580-4.

BackgroundBuried bumper syndrome has been regarded as an uncommon and late complication after percutaneous endoscopic gastrostomy (PEG) tube insertion. A variety of techniques have been reported to treat this problem, but only a few published cases exist.ObjectiveOur purpose was to present the clinical manifestations and our management of a series of 19 patients with buried bumper syndrome.DesignCase series study.SettingReferral medical centers.PatientsWithin 5 years, 31 episodes of buried bumper syndrome occurred in 10 men and 9 women. The estimated prevalence was 8.8% (19 in 216 PEG procedures during this period).InterventionAll the buried tubes were removed smoothly by external traction and replaced with a new pull-type feeding tube by the pull method or a button or balloon replacement tube after dilation of the old tract.Main Outcome MeasurementsSuccess rate, complication rate.ResultsThe duration between occurrence of buried bumper syndrome and PEG placement ranged from 1 to 50 months, with a median of 18 months. All the episodes were treated successfully except for one, in which reinsertion failed and a new PEG tube was inserted 1 week later. No significant complications occurred.LimitationSmall sample size.ConclusionsBuried bumper syndrome is not that uncommon and can occur soon after insertion of a PEG tube. The buried tube can be safely removed by external traction and in most cases can then be replaced with a pull-type or balloon replacement tube.

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