A 66-year-old woman was admitted to our hospital for persistent vomiting after replacement of percutaneous endoscopic gastrostomy (PEG) catheters at another hospital. Abdominal computed tomography revealed a PEG catheter bumper retained in the stomach, which appeared to be the cause of vomiting. Although we attempted to retrieve the bumper with a retrieval net and grasping forceps employing upper gastrointestinal endoscopy, high resistance at the gastroesophageal junction hampered our efforts. While the bumper was endoscopically grasped, two bumper legs were cut with a laparoscopic surgical scalpel inserted from the fistula. The bumper was then safely retrieved, employing grasping forceps, without resistance.
Endoscopic retrieval is recommended for retained PEG internal bumper, but can be difficult in certain cases. We herein report a case in which a PEG internal bumper was safely retrieved in combination with a trans-fistula approach.
