Feature Article

Abdominal pain: is it the pancreas?

Andrew V Biankin, Peter Cosman, Neil D Merrett



Pancreatic diseases are generally poorly understood, frequently misdiagnosed and inadequately treated. This article outlines the symptoms of pancreatic pathology and guides the practitioner through various investigations.

Key Points

  • For patients over the age of 50 years with abdominal pain, one should have a high level of suspicion for the presence of underlying malignancy, particularly of the pancreas.
  • Any demonstrated abnormality of the pancreas should be investigated further and treated as pancreatic cancer until proven otherwise.
  • Any masses should be assessed by specialists in the field for further treatment.
  • Patients with chronic pancreatitis are at risk for pancreatic malignancy and should be followed up by a gastroenterologist or a pancreatic surgeon.
  • Percutaneous biopsy should not be performed prior to assessment of resectability because of the risk of the tumour seeding along the needle tract and thereby eliminating any chance of cure.