Buried bumper syndrome

Case contributed by Fakhry Mahmoud Ebouda

Presentation

Female with PEG tube malfunction.

Patient Data

Age: 45 years
Gender: Female
ct

The percutaneous gastrostomy tube is introduced with the external opening seen through the left anterolateral aspect of the abdominal wall. Dislodgement of the internal bumper of the PEG tube into the anterior abdominal wall outside the peritoneum. The PEG tube with its bumper is buried in the anterior abdominal wall just superficial to the rectus abdominis associated with a small amount of fluid/scar tissue near the end of the tube bumper extending to the gastric antrum. The surrounding left lateral abdominal wall muscles appear bulky, showing edematous changes likely the sequelae of tube insertion.

Case Discussion

Buried bumper syndrome is a rare complication in patients with a percutaneous gastrostomy tube if the tube is migrated and malpositioned along its tract. The tube may get lodged anywhere between the gastric wall and the skin. The complications may be life-threatening including hemorrhage, infection, peritonitis, abscess formation, hollow viscus perforation and necrosis.

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