The Buried Bumper Syndrome and Gas in the Portal Venous System

Abstract

Purpose: A case of Buried Bumper Syndrome accompanied by gas in the hepatic portal venous system is reported. A 77 year-old man with a recent stroke and percutaneous gastrostomy (PEG) tube placement two months previously for dysphagia was admitted to our institution with complaints of acute pain at the PEG tube site. An abdominal computed tomography revealed that the internal bumper had migrated from the gastric lumen into the abdominal wall, otherwise known as the Buried Bumper Syndrome. Incidentally, gas was also discovered in the portal venous system. With the advancement of CT imaging, the incidence of detecting hepatic portal venous gas has risen. Traditionally associated with a grim prognosis, hepatic portal venous gas has now been linked to a wider array of pathologies. After undergoing an endoscopy, with removal of the buried internal bumper and replacement of the PEG tube, the patient had an uneventful recuperation. To our knowledge, there have been no cases reported of gas in the portal venous system coinciding with the Buried Bumper Syndrome.[figure1][figure2]FigureFigure