Published online Aug 28, 2014. doi: 10.3748/wjg.v20.i32.11439
Revised: March 11, 2014
Accepted: April 28, 2014
Published online: August 28, 2014
Percutaneous endoscopic gastrostomy (PEG) is a common practice for long-term nutrition of patients who are unable to take oral food. We report of an 85-year old man with a history of recurrent larynx carcinoma and hemicolectomy many years ago due to unknown reason. Laryngectomy was indicated. Preoperatively a PEG was inserted endoscopically after an abdominal ultrasonography without abnormal findings. Few months after PEG insertion, the patient was evaluated for diarrhea and insufficient feeding without signs of infection or peritonism. An upper endoscopy and computed tomography scan confirmed a buried bumper syndrome with migration of the PEG tube into the colon as a rare complication. He underwent successful colonoscopic removal of the internal bumper and closure of the colonic orifice of the fistula with the over-the-scope-clip system (OTSC). OTSC is an endoscopic device for treatment of bleeding, perforation, leak and fistula in the gastrointestinal tract. To the best of our knowledge, this is the first report of the use of OTSC for colonoscopic closure of a gastrocolocutaneous fistula due to a buried bumper syndrome with transcolonic PEG tube migration.
Core tip: We present a case of buried bumper syndrome with percutaneous endoscopic gastrostomy tube migration into the transverse colon that was treated endoscopically using the over-the-scope-clip (OTSC) system for closure. OTSC is a new endoscopic device for treatment of bleeding, perforations, leaks and fistulae in the gastrointestinal tract.