Buried bumper syndrome is caused by what mechanism, and what is its prevalence?

• A. Erosion of internal bolster into gastric mucosa; 0.3-2.4%
• B. Tearing of mucosa due to excessive suction; 1-5%
• C. Infection around tube tract; 30%
• D. Colon puncture causing fistula; 0-0.27%

Answer: (A)

Buried bumper syndrome happens when the internal bumper of a gastrostomy tube is pressed into and erodes through the gastric mucosa due to chronic pressure from a tight external bumper or excessive tube tension. Over time, this pressure causes ischemia and friction at the stomach wall, so the bumper becomes buried within the gastric wall or lumen and the tube can no longer function normally. This complication is relatively uncommon, with prevalence estimates around 0.3% to 2.4% in adults. Other described issues, like tearing of mucosa from suction, infection around the tube tract, or colon-related fistulas, are different complications and do not define buried bumper syndrome.