What causes buried bumper syndrome?

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

Answer: (B)

Buried bumper syndrome happens when the internal bumper of a gastrostomy tube is pressed too tightly against the stomach wall, leading to pressure ischemia and erosion into the gastric mucosa. Over time, tissue grows over the embedded bumper, so the internal foreign body becomes buried in the gastric wall and the tube becomes difficult or impossible to move. This can cause leakage around the stoma, tube dysfunction, and risk of infection. The other scenarios describe different problems (bowel obstruction isn’t caused by bumper erosion, external discharge is a symptom of a leak, and migration into the colon is a different misplacement issue), but they don’t explain the mechanism of the bumper becoming buried within the gastric tissue.