Percutaneous endoscopic gastrostomy risk assessment — ESEGH MCQ

Correct answer: B — Defer PEG pending a goals-and-risk team review

The best answer is “Defer PEG pending a goals-and-risk team review”. Nutrition access is a goals-and-risk decision, not an automatic response to calorie need; ascites and coagulopathy materially increase harm. “Insert PEG immediately because enteral feeding routinely prevents aspiration” is less appropriate because PEG does not eliminate aspiration and the procedural risks are high “Use colonoscopy to place the gastrostomy” is less appropriate because this is not how PEG access is created “Start infliximab before PEG” is less appropriate because immunosuppression has no role in correcting these risks “Give loperamide to prevent aspiration” is less appropriate because antimotility treatment does not protect the airway

Reference: NICE CG32 nutrition support: https://www.nice.org.uk/guidance/cg32/chapter/Recommendations