Gastric ulcer at the bumper site
Friday 19 June 2009, Branislav Kunčak, M. D.
Complication of percutaneous endoscopic gastrostomy (PEG): gastric ulcer at the bumper site.
Excessive tension between the internal and external bumpers can lead to ischemic necrosis of the gastric mucosa and subsequent ulceration at the bumper site. Healing and epithelisation may cause mucosal overgrowth and burying the inner bumper (buried bumper syndrome).
Bigger image, Endoscopy
Fig. 2
The outer bumper was loosened. PEG feed was stopped and PPI treatment was initiated. The next day the patient had to be operated on because of signs of acute abdomen. The ulcer perforation was found at laparotomy.
