Post written by Andrew Storm, MD, and Navtej Buttar, MD, from Mayo Clinic, Rochester, Minnesota, USA.

Managing buried bumper that is complicating PEG tube placement may be challenging and risky, particularly when this occurs acutely after PEG tube placement, where simple PEG tube removal to permit healing is impossible.

In this case, we describe the use of OverStitch (Apollo Endosurgery, Austin, Tex, USA) sutured repair of the anterior gastric ulcer created by the buried bumper after PEG gastropexy before PEG tube replacement with a modified, larger bumper using part of a Jackson-Pratt drain bulb (Cardinal Health, Dublin, Ohio, USA) to more broadly distribute the gastropexy forces leading to the buried bumper.

Given the success of this technique for our patient, we hope that others may use this or further develop techniques for the endoscopic repair of buried bumper.

Endoscopic image revealing the final position of the modified PEG bumper.

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.