title: [The buried gastrostomy bumper syndrome].
abstract: The buried gastrostomy bumper syndrome is one of the rare complications of PEG (percutaneous endoscopic gastrostomy) insertion. It develops when there is a combination of a rigid bumper and a tension build-up between internal and external bumpers. This condition is manifested by complete occlusion of the internal opening of the gastrostomy by mucosa, making it impossible to feed the patient. We report a case in which the PEG was inserted a year prior to the appearance of this rare complication. It was embedded beneath the gastric mucosa and we had difficulty in removing it to insert a new PEG. The bumpers are anchor-like attachments to each end of the gastrostomy, which keep it stationary. The rigid bumper is an integral part of the gastrostomy. However, a "soft" bumper has been developed, but its costliness has restricted its use. In our case the gastrostomy was removed with the aid of the cutting wire of a sphincterotome in light contact with the external tissue.
authors.affiliation: Dept. of Gastroenterology, Hillel Yaffe Medical Center, Hadera.
authors.forename: Z
authors.initials: Z
authors.lastname: Fireman
authors.forename: N
authors.initials: N
authors.lastname: Yunis
authors.forename: D
authors.initials: D
authors.lastname: Coscas
authors.forename: D
authors.initials: D
authors.lastname: Zamir
authors.forename: Y
authors.initials: Y
authors.lastname: Wagner
authors.forename: A
authors.initials: A
authors.lastname: Sternberg
mesh_terms: D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D013577:Syndrome