Percutaneous endoscopic gastrostomy (PEG) tube has been used to provide long-term nutritional support for patients who are unable to maintain sufficient oral intake. Buried bumper syndrome (BBS) is an uncommon complication of PEG tube insertion that can be associated with serious complications. We report a case an 82-year-old man who presented with BBS that occurred eight months after PEG tube insertion. The migrated PEG tube was removed and fortunately, the patient's swallowing had improved to allow sufficient oral intake. Clinicians should consider BBS in any patients with PEG tube who present with difficulty with feeding or tube blockage.
Complications ; Foreign-Body Migration ; Endoscopy ; Gastrostomy

Introduction: Pressure ulcers are very common, however their incidence varies widely between hospitals. To date there are no published data available for pressure ulcers in Brunei Darussalam. This study was designed to look at the incidence and risk factors of pressure ulcers among medical patients in RIPAS Hospital. Materials and Methods: All medical patients admitted to all five medical wards during the month of May 2010 were included and identified. A proforma based on the European Pressure Ulcer Advisory Panel (EPUAP) model was used and modified to include several factors that may contribute to the risk of developing new pressure ulcers. The proforma was completed by the attending physician during the patient's admission and then subsequently followed up by the parent admitting team until discharge. Results: There were a total of 305 patients (104 male and 201 female) with a mean age of 48.9 ± 20.4 years. There were five patients with pressure ulcers (1.6%), four of which developed during hospital stay and one patient admitted with an ongoing pressure ulcer. All five patients were female, had co-morbidities, were bed-bound and unwell during admission. On comparison to those without pressure ulcers, patients were significantly older, had more co-morbidities, being bed bound, admissions to intensive care unit and had lower serum haemoglobin (p<0.05), albumin (p<0.05) and total protein (p<0.05) on admission. Two patients died during their in-patient stay due to other medical illness. The remaining patients had prolonged hospital stay (over 30 days). Conclusions: The study showed an incidence of 1.6% pressure ulcers among medical patients in RIPAS Hospital. We identified several factors that are significant in increasing patients’ risk of developing pressure ulcers.