Buried Bumper Syndrome: Endoscopic Management Using a Balloon Dilator

Strock, Paul; Weber, J.

doi:10.1055/s-2005-861015

Cited by 18 publications

(9 citation statements)

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“…Burial of the Retainer in the Gastric Wall (Buried Bumper Syndrome) There are several ways to resolve this complication: (1) Introduce a dilatation balloon [32] or a Savary dilator with a diameter slightly greater than that of the probe [33] through the lumen of it and push to the gastric cavity until the retainer is unstuck. For this maneuver, we can help ourselves by pulling the dilator with a polypectomy snare introduced through the working channel of the endoscope.…”

Section: Some Tricks To Resolve Some Complicationsmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy

Rosés¹,

Castro²

2009

Frontiers of Gastrointestinal Research

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Percutaneous endoscopic gastrostomy (PEG) has become one of the most frequently used procedures to administer nutrition and also as an alternative to the surgical approach or nasogastric tubes. The technique is simple, safe and cheap; it can be performed by any moderately experienced endoscopist and so, since the original description in 1980, has become a popular method around the world. The main PEG indication is the nutrition of patients that cannot swallow, although there are other utilities. Contraindications and complications are very unusual in clinical practice. There are three technical modalities for the placement of the gastrostomy tube, with no one being better than the other. This chapter tries to explain in a very practical way the main aspects of the procedure and it especially focuses on technical points, incorporating some useful tricks that can help solve some eventually embarrassing situations.

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Section: Some Tricks To Resolve Some Complicationsmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy

Rosés¹,

Castro²

2009

Frontiers of Gastrointestinal Research

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“…The Buried Bumper Syndrome (BBS) was first described in the 1990s and is a rare complication of PEG placement. The reported incidence in literature ranges from 0.3% to 2.4% (1)(2)(3)(4)(6)(7)(8)(9)(10)(11)(12). The main etiological factor leading to BBS, is excessive traction between the external and internal bumper of the PEG-tube causing ischemia, necrosis and ulceration of the overlying gastric mucosa (1)(2)(3)(4)(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

“…The reported incidence in literature ranges from 0.3% to 2.4% (1)(2)(3)(4)(6)(7)(8)(9)(10)(11)(12). The main etiological factor leading to BBS, is excessive traction between the external and internal bumper of the PEG-tube causing ischemia, necrosis and ulceration of the overlying gastric mucosa (1)(2)(3)(4)(6)(7)(8)(9)(10)(11)(12). This eventually may lead to partial transmural migration, where the bumper is still partly visible from within the gastric lumen (incomplete BBS), or to a complete migration through the gastric wall (complete BBS) (2,3).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic management of buried bumper syndrome using the Balloon Dilation Pull (BDP) technique: a multicenter analysis

Maly¹,

Bronswijk²,

Christiaens³

et al. 2023

AGEB

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Background and study aims: Buried bumper syndrome (BBS) may complicate percutaneous endoscopic gastrostomy placement. In these patients, endoscopic treatment ought to be considered. Various approaches have been published, ranging from dissectionbased techniques to novel dedicated devices, although the evidence supporting the use of the Balloon Dilation Pull (BDP) technique has been limited to single case reports. The aim of this paper is to assess the feasibility, efficacy and safety of the systematic use of the BDPtechnique for the endoscopic treatment of BBS. Patients and methods: We performed a retrospective multicenter analysis of prospectively collected data from all patients treated with the BDP-technique between January 2011 and November 2021. Results: In total, 26 patients were identified (median age 72 (SD ± 13) years, 74% male, 84.6% underlying neurological disease). Technical success was achieved in 92.3%, with a median procedure time of 17.5 minutes (range 5-27). Adverse events were identified in 3.8% of patients (N=1, aspiration, ASGE lexicon severity grade: moderate). Conclusions: Our experience suggests that the BDP-technique is highly efficacious and safe, using accessories readily available in every endoscopic unit. Given the limited procedure time and tools required, this procedure has the potential to further optimize patient care in the context of BBS.

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“…However, long-term PEG feeding, improper feeding tube care, and potentially smaller or harder discs have been associated with development of buried bumper syndrome in approximately 1.5 % of patients [1][2][3][4]. Although more and more techniques have been described and even dedicated tools developed [1][2][3][4], simple balloon-assisted buried bumper management may carry several advantages [5]. A 68-year-old patient with a history of hemiparesis following a stroke was referred to our department for a leaking PEG tube with jejunal extension.…”

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confidence: 99%