A Rare Complication of Percutaneous Endoscopic Gastrostomy Tube Placement: Early Buried Bumper Syndrome (BBS)

Abstract

Early Buried Bumper Syndrome (BBS) is a rare complication of Percutaneous Endoscopic Gastrostomy (PEG) tube placement where the internal bolster gets “buried” in the gastrocutaneous fistulous tract. BBS is usually a late complication. We present a case of early BBS, in Radiology Department of Dr Ziauddin Hospital, Karachi. Patient presented with fever and oozing from the side of PEG tube. CT scan abdomen findings revealed, the bumper of the percutaneous endoscopic gastrostomy tube retracted in subcutaneous fat just adjacent to the gastric wall and seen in the left sided rectus sheath outside the gastric lumen. Contrast was given through the peg during the procedure which show no extravasation of contrast in adjacent soft tissues. These findings consistent with early buried bumper syndrome.