Buried bumper syndrome causing rectus abdominis necrosis in a man with tetraplegia

作者：Johnson T^*; Velez K A; Zhan E

来源：Spinal Cord, 2010, 48(1): 85-86.

DOI：10.1038/sc.2009.67

• buried bumper syndrome
• percutaneous endoscopic gastrostomy
• complications
• tetraplegia

Study design: Case report.
Objectives: To enhance the early recognition of buried bumper syndrome in patients with tetraplegia requiring percutaneous endoscopic gastrostomy (PEG).
Setting: Inpatient unit, Massachusetts, USA.
Methods: A 44 year-old man with C2 American Spinal Injury Association grade A tetraplegia with a relatively recent PEG insertion secondary to poor nutritional intake.
Results: Several months after PEG placement, patient became febrile, hypotensive and complained of abdominal pain. Plain films showed a dilated bowel suggestive of ileus. Abdominal and pelvic computed tomography with and without contrast revealed PEG tube dislodgement, and a 21cm x 2.8cm left anterior abdominal wall collection consisting of air and contrast. Upon surgical intervention, the left rectus abdominis sheath and muscle were found to be necrotic.
Conclusion: Buried bumper syndrome is a serious complication related to PEG tubes. For many people with tetraplegia, PEG is a life-saving procedure with minimal risks. However, emergencies do occur, making prompt recognition imperative to prevent a fatal sequela. Spinal Cord (2010) 48, 85-86; doi:10.1038/sc.2009.67; published online 16 June 2009

• 出版日期2010-1