Buried bumper syndrome

Written by chris hamilton
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A percutaneous endoscopic gastrostomy tube, commonly known as a feeding or PEG tube, gives nutrition to patients unable to feed themselves. The tube is surgically inserted into the patient’s stomach, and nutrients are fed through the endoscopic tube. Buried bumper syndrome occurs when the PEG tube migrates between the stomach wall and the skin. It's a serious complication that can require surgery.

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The PEG tube can move on its own due to thinning or retraction of the stomach lining. New cells will then grow around the end of the tube. This causes a mucus filled cavity (fistula) to grow on the outside of the stomach wall. Mucosa can leak into the body or the fistula can burst, both of which can cause death if not treated.

Time Frame

Buried bumper syndrome usually becomes an issue when the tube has been installed for a long period of time, which can be the case with dementia patients. The complication rarely occurs after three years, but can occur as early as nine days. According to the Internet Journal of Gastroenterology, early bumper buried syndrome may be more common than previously thought, but the problem is not recognised until it causes serious complications.

Symptoms

Patients suffering from buried bumper syndrome may complain of abdominal pain after feeding and experience nausea, vomiting, diarrhoea, bloating or general tightness in the abdominal area. They may also show signs of an infection.

Identification

Indicators of late buried bumper syndrome include a gastric fistula, which will appear on the abdomen as a deep red circle. Once infected, a gastric fistula can cause patients severe abdominal pain. Gastroenterologists, doctors who study the digestive tract, can detect buried bumper syndrome with a computerised scan of the body. In order to verify the results of the scan, doctors may perform a laparotomy, which is a small incision made in the abdominal wall.

Solution

After recognising the rare condition of buried bumper syndrome, a gastroenterologist may remove the fistula and feeding tube while performing the laparotomy. Because buried bumper syndrome is not readily identified by doctors and patients, and since many of those afflicted with suffer from stroke or dementia, the mortality rate can be high.

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