{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:30:42Z","timestamp":1792139442140,"version":"4.4.0"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2014,11,1]]},"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Buried bumper syndrome (BBS) is an uncommon but significant complication of percutaneous endoscopic gastrostomy (PEG), which occurs due to overgrowth of gastric mucosa over the inner bumper of the gastrostomy tube. A high incidence of BBS was observed in patients with Freka PEG tubes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To review case numbers of BBS and confirm the observed association with Freka tubes to determine whether change of practice should be considered.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Data was collected on the number of cases of BBS reported to the community nutrition team Birmingham, UK. Data on type of PEG kit and total number of PEGs inserted between 2009 and 2013 were collected. The electronic endoscopy reporting database was used to compare case numbers of BBS in our Trust in years when Corflo and Freka PEG tubes were used, respectively. Data from our Trust were also compared with that from a Trust using Corflo only.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty-eight cases of BBS were reported in the area covered by the Birmingham community nutrition team between 2009 and 2013, all of which were associated with Freka PEG tubes. An estimated 1000\u20131200 PEGs were inserted during this period, representing an incidence of BBS of 4.8\u20135.8%. No cases of BBS occurred over the same period in the comparison Trust (451 Corflo PEGs inserted).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our review confirmed our observation of an increased risk of BBS with Freka PEG tubes. Clinicians should be aware of our findings when deciding which brand of PEG tube to insert, particularly in patients with a previous history of BBS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2014-100503","type":"journal-article","created":{"date-parts":[[2014,11,25]],"date-time":"2014-11-25T23:37:37Z","timestamp":1416958657000},"page":"194-198","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Observed high incidence of buried bumper syndrome associated with Freka PEG tubes"],"prefix":"10.1136","volume":"6","author":[{"given":"Joanna K","family":"Dowman","sequence":"first","affiliation":[{"name":"Sandwell and West Birmingham NHS Trust, City Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Ditchburn","sequence":"additional","affiliation":[{"name":"Sandwell and West Birmingham NHS Trust, City Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren","family":"Chapman","sequence":"additional","affiliation":[{"name":"Sandwell and West Birmingham NHS Trust, City Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Par","family":"Lidder","sequence":"additional","affiliation":[{"name":"Sandwell and West Birmingham NHS Trust, Sandwell General Hospital, West Bromwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Wootton","sequence":"additional","affiliation":[{"name":"Sandwell and West Birmingham NHS Trust, City Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Ryan","sequence":"additional","affiliation":[{"name":"Sandwell and West Birmingham NHS Trust, Sandwell General Hospital, West Bromwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M","family":"Cooney","sequence":"additional","affiliation":[{"name":"Sandwell and West Birmingham NHS Trust, City Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,11,25]]},"reference":[{"key":"2025090708073180000_6.3.194.1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533608318673"},{"key":"2025090708073180000_6.3.194.2","first-page":"312","article-title":"Buried bumper syndrome: low incidence and safe endoscopic management","volume":"74","author":"El","year":"2011","journal-title":"Acta Gastroenterol Belg"},{"key":"2025090708073180000_6.3.194.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(97)00030-0"},{"key":"2025090708073180000_6.3.194.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-009-0381-y"},{"key":"2025090708073180000_6.3.194.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-006-9114-7"},{"key":"2025090708073180000_6.3.194.6","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1007\/s00464-008-0299-9","article-title":"Percutaneous endoscopic gastrostomy tube removal and replacement after \u201cburied bumper syndrome\u201d: the simple way","volume":"23","author":"Turner","year":"2009","journal-title":"Surg Endosc"},{"key":"2025090708073180000_6.3.194.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2005.06.013"},{"key":"2025090708073180000_6.3.194.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-007-9224-x"},{"key":"2025090708073180000_6.3.194.9","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S0016-5107(89)72735-8","article-title":"PEG feeding tube migration impaction in the abdominal wall","volume":"35","author":"Schwartz","year":"1989","journal-title":"Gastrointest Endosc"},{"key":"2025090708073180000_6.3.194.10","doi-asserted-by":"publisher","DOI":"10.1097\/00129689-200210000-00010"},{"key":"2025090708073180000_6.3.194.11","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1308\/rcsann.2012.94.1.61b","article-title":"A novel laparoscopic approach for the surgical management of buried bumper syndrome","volume":"94","author":"Ehsan","year":"2012","journal-title":"Ann R Coll Surg Engl"},{"key":"2025090708073180000_6.3.194.12","unstructured":"National Institute for Health and Care Excellence Clinical Guideline 32: Nutrition support in adults: Oral nutrition support, enteral tube feeding and parenteral nutrition (2006)."}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2014-100503","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T15:07:39Z","timestamp":1757257659000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2014-100503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,25]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2015,6,9]]},"published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1136\/flgastro-2014-100503"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2014-100503","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"value":"2041-4137","type":"print"},{"value":"2041-4145","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11,25]]}}}