What is the incidence of buried bumper syndrome in PEG tube placement?

• A. 10-20%
• B. 0.3-2.4%
• C. 5-7%
• D. 25-30%

Answer: (B)

Buried bumper syndrome after PEG tube placement is a relatively uncommon complication. It happens when the internal bumper sinks into or becomes embedded in the gastric wall or abdominal tissues, usually due to excessive tension from the external bumper, tissue overgrowth, or long-term traction. Because this is not a frequent event but one that can derail feeding and require endoscopic or surgical management, understanding its incidence helps clinicians appreciate why vigilance is needed without overestimating risk.

Across multiple studies and reviews, the incidence is reported in the low single digits, specifically about 0.3% to 2.4%. This range reflects differences in study designs, definitions, and how long patients were followed, but it consistently shows that while the event is serious, it is relatively rare. Higher percentages would imply a much more common problem and aren’t supported by the bulk of literature. Keeping the external bumper not overly tight and monitoring for symptoms like feeding intolerance, leakage, or a change in the tube’s mobility helps catch this complication early before it progresses.