Buried Bumper Syndrome With Full Gastric Wall Penetration Managed With Delayed Replacement: A Conservative Approach.

Buried bumper syndrome is an uncommon but serious complication of gastrostomy tube placement, in which the internal bumper migrates into the gastric wall or beyond. Complications include bleeding, perforation, peritonitis, and death. We present a case of a 21-year-old man with Batten disease who presented with abdominal pain, swelling, and leakage from his gastrostomy tube. Imaging revealed that the balloon had advanced through the gastric wall, and an endoscopy was performed. Endoscopic examination revealed buried bumper syndrome with full gastric wall penetration. The tube was removed, and replacement was delayed for eight days to allow mucosal healing, with proton pump inhibitors used during this time. A new tube was successfully replaced. This case highlights an important learning point: delayed replacement can be a viable strategy in avoiding surgery in buried bumper syndrome when endoscopic placement is not otherwise feasible.