Buried bumper syndrome is caused by erosion of which structure?

• A. Migration of the tube into the colon
• B. External bumper infection
• C. Bowel obstruction
• D. Erosion of the internal bolster into the gastric mucosa

Answer: (D)

Buried bumper syndrome happens when the internal bolster of a gastrostomy tube presses against and erodes into the gastric mucosa. Over time, constant pressure or traction causes tissue necrosis, so the bumper becomes embedded within the stomach wall and the tube can no longer be externalized or advanced. This erosion into the gastric mucosa is the defining mechanism and leads to the characteristic buried feel and feeding issues.

The other scenarios don’t fit because migrating into the colon would imply the tube itself moves into the colon rather than the bumper eroding into gastric tissue; external bumper infection involves the skin around the tube, not erosion of the internal part; bowel obstruction is a separate complication and not the mechanism of this condition.