Which statement best describes Buried Bumper Syndrome?

• A. External bumper becomes loose
• B. PEG is removed
• C. Tube becomes dislodged
• D. Internal bumper becomes embedded into abdominal wall and gastric mucosa epithelializes over tube

Answer: (D)

Buried Bumper Syndrome happens when the internal bumper of a PEG tube is pressed into the gastric wall and becomes embedded, with the surrounding mucosa growing over the tube. This occurs when the external bumper is tightened too much or there’s excessive traction, causing the internal bumper to erode into the stomach lining and/or abdominal wall. The key feature is the internal bumper being buried and epithelialized over the tube, which explains why the tube can become difficult to move, cause feeding resistance or leakage, and may require endoscopic or surgical management to free or replace the tube. The other scenarios describe different PEG problems (loose external bumper, removal, or tube dislodgement) but do not capture the embedding process that defines Buried Bumper Syndrome.