title: Clinical manifestations and management of buried bumper syndrome in patients with percutaneous endoscopic gastrostomy.
abstract: BACKGROUND
  Buried 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.
  
  
  OBJECTIVE
  Our purpose was to present the clinical manifestations and our management of a series of 19 patients with buried bumper syndrome.
  
  
  METHODS
  Case series study.
  
  
  METHODS
  Referral medical centers.
  
  
  METHODS
  Within 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).
  
  
  METHODS
  All 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.
  
  
  METHODS
  Success rate, complication rate.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Small sample size.
  
  
  CONCLUSIONS
  Buried 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.
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, Far Eastern Memorial Hospital, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Tzong-Hsi
authors.initials: TH
authors.lastname: Lee
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D020878:Device Removal / Q000379:methods*; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D013577:Syndrome; D016896:Treatment Outcome