Necrotizing Fasciitis Secondary to Acute Buried Bumper Syndrome

May chronic cough in chronic obstructive pulmonary disease be a contraindication of Percutaneous Endoscopic Gastrostomy placement: a case report

“…This is according to Richter-Schraq HJ et al who described 4 types of BBS: in type 1 the internal bumper is outside the body or in the subcutaneous tissue; in type 2 the internal bumper is partially visible in gastric lumen; in type 3 the internal bumper is not visible in the gastric lumen and is in the most superficial layers of the gastric wall; in type 4 the internal bumper is not visible in the gastric cavity and is in the deeper layers of the gastric wall [ 7 ]. BBS is a dangerous major complication of the PEG placement because it may cause infection, necrotizing fasciitis [ 3 , 10 ], peritonitis and consequently septic shock with a fatal outcome [ 8 ]. Absolute contraindication to PEG placement are pharyngeal and esophageal occlusion for pull technique, active serious coagulopathy, hemodynamic instability, sepsis, severe ascites, peritonitis, peritoneal carcinomatosis, portal hypertension with gastric varices, total gastrectomy [ 1 , 11 ].…”

Buried Bumper Syndrome: A Case Report of a Rare Complication of Percutaneous Endoscopic Gastrostomy

“…BBS may present with bleeding, perforation [1], peritonitis, abscess and phlegmon [7], but also, rarely, as necrotizing fasciitis [11], rectus abdominis necrosis [12], or with co-existence of encephalopathy and high anion gap metabolic acidosis [13]; these complications could be potentially lethal. Microbes isolated from the tube or the wound are rarely described in the literature, but they can include Klebsiella pneumonia and Candida vulgaris [7].…”