Abstract
Buried bumper syndrome (BBS) was described as a complication of percutaneous endoscopic
gastrostomy (PEG) that occurs when the internal stump of the probe migrates and is
located between the gastric wall and the skin. The increase of compression between
the internal stump and the external stump of the gastrostomy tube causes pain and
the inability to feed. We present the cases of three patients with BBS managed by
the metabolic and nutritional support department. These cases intend to illustrate
one of the less frequent complications of PEG, clinical presentation, risk factors,
diagnosis, and especially clinical management. Although there are no defined gold
standards for its management, the most important points in the management of this
condition are early recognition, recommendations to avoid ischemic process at the
moment of the insertion of the tube, specific care of the gastrostomy tube, and a
periodic nutrition evaluation to avoid overweight, which causes traction and excessive
pressure in the gastric wall. It is important for physicians to be aware of the recommendations
to prevent BBS and its complications, especially in patients in whom communication
can be difficult secondary to their pathologies and comorbidities.
Keywords
buried bumper syndrome - percutaneous endoscopic gastrostomy - major complication
- internal stump
