PEG reimplantation after Buried Bumper Syndrome: a case report.

Fabiola Fornaroli; Noemi Gualandi; Francesca Vincenzi; Luigi Laghi; Gian Luigi de'Angelis; Federica Gaiani

doi:10.23750/abm.v93iS1.12515

PEG reimplantation after Buried Bumper Syndrome: a case report.

Authors

Fabiola Fornaroli Gastroenterology and Endoscopy Unit, University Hospital of Parma, via Gramsci 14, 43126, Parma, Italy.
Noemi Gualandi Gastroenterology and Endoscopy Unit, University Hospital of Parma, via Gramsci 14, 43126, Parma, Italy.
Francesca Vincenzi Gastroenterology and Endoscopy Unit, University Hospital of Parma, via Gramsci 14, 43126, Parma, Italy.
Luigi Laghi Gastroenterology and Endoscopy Unit, University Hospital of Parma, via Gramsci 14, 43126, Parma, Italy; Department of Medicine and Surgery, University of Parma, via Gramsci 14, 43126, Parma, Italy
Gian Luigi de'Angelis Gastroenterology and Endoscopy Unit, University Hospital of Parma, via Gramsci 14, 43126, Parma, Italy; Department of Medicine and Surgery, University of Parma, via Gramsci 14, 43126, Parma, Italy
Federica Gaiani a:1:{s:5:"en_US";s:86:"Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma";}

DOI: https://doi.org/10.23750/abm.v93iS1.12515

Keywords:

Percutaneous Endoscopic Gastrostomy, Buried Bumper Syndrome, Complication, Cellulitis, Enteral nutrition

Abstract

Percutaneous endoscopic gastrostomy (PEG) is the method of choice to provide long-term enteral nutrition for patients with impossibility to be fed orally.

Although it is considered a routine and safe procedure, potential complications exist, which are generally classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use, such as buried bumper syndrome (BBS). BBS is a life-threatening complication, occurring in 0.3% to 2.5% of cases. Additional complications related to BBS may present, such as wound infection, peritonitis, and necrotizing fasciitis. Once resolved the acute complication, an adequate feeding method should be prompted for the patient, among whom PEG remains of choice. After tissue inflammation, fibrosis may prevent a standard endoscopic procedure for the new implantation, therefore endoscopists should modulate procedures to obtain successful and safe results. A combined surgical- and endoscopic strategy could resolve implantation difficulties ensuring a safe and simple procedure.We present here a case of BBS complicated with abdominal wall cellulitis in a paraplegic 35-year-old-man who was admitted to our hospital.

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