Aralık 2015

82-83

Şehmus ÖLMEZ¹, Bünyamin SARITA޲, Mesut AYDIN¹, Ergin TURGUT³

Departments of 1Gastroenterology, 3Internal Medicine, Yüzüncü Yıl University, School of Medicine, Van Department of 2Gastroentrology, Medical Park Hospital, Elazığ

Perkütan endoskopik gastrostomi, normal bağırsak fonksiyonları olan, ancak değişik nedenlerle yutamayan hastalarda uzun dönemli beslenmeyi sağlamada etkin ve güvenilir bir yöntemdir. Bazı hastalarda gastrostomi tüpünün mide duvarı içine ilerlemesi sonucu nadir görülen bir komplikasyon olan buried bumper sendromu görülebilir. Burada buried bumper sendromu olan ve Savary-Gilliard bujisi ile başarılı bir şekilde tedavi edilen bir hastayı sunacağız.

Buried bumper sendromu, Savary-Gilliard dilatatör

Percutaneous endoscopic gastrostomy (PEG) is a safe and effective method for providing long term enteral nutrition in patients who cannot swallow, but who have intact gut function (1,2). A complication of migration of the internal bumper into the gastric or abdominal wall is called ‘‘buried bumper syndrome’’ and was described (BBS) by Klein et al (3). Surgical and endoscopic treatments are performed to treat BBS. Although, endoscopic techniques vary, treatment with Savary-Gilliard dilator (SGD) is a rarely used method (4,5). Here we report a case of buried bumper syndrome successfully treated with SGD, which included the placement of a new PEG tube

BBS is a rare, serious, and late complication of PEG insertion, with a prevalence ranging from 0.3% to 2.4% (4). Several endoscopic treatment options may be used for BBS, but there is no standardized method. Endoscopic treatment should be used in high risk patients. We think that endoscopic treatment with SGD is an easily applicable, effective and safe method for the removal of a PEG tube

BBS is a rare, serious, and late complication of PEG insertion, with a prevalence ranging from 0.3% to 2.4% (4). Several endoscopic treatment options may be used for BBS, but there is no standardized method. Endoscopic treatment should be used in high risk patients. We think that endoscopic treatment with SGD is an easily applicable, effective and safe method for the removal of a PEG tube

1. Larson DE, Burton DD, Schroeder KW, DiMagno EP. Percutaneous endoscopic gastrostomy: indications, success, complications, and mortality in 314 consecutive patients. Gastroenterology 1987;93:48-52. 2. Nicholson FB, Korman MG, Richardson MA. Percutaneous endoscopic gastrostomy: a review of indications, complications and outcome. J Gastroenterol Hepatol 2000;15:21-5. 3. Klein S, Heare BR, Soloway RD. The ‘‘buried bumper syndrome’’: a complication of percutaneous endoscopic gastrostomy. Am J Gastroenterol 1990;85:448-51. 4. Lee TH, Lin JT. Clinical manifestations and management of buried bumper syndrome in patients with percutaneous endoscopic gastrostomy. Gastrointest Endosc 2008;68:580-4. 5. Rieder B, Pfeiffer A. Treatment of the Buried Bumper Syndrome using a Savary Dilator. Endoscopy 2008;40(Suppl 2):E115.