Pancreatic conditions: Assessment and management

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Unit 635

July 2026

Pancreatic conditions: Assessment and management

The purpose of this activity is to build general practitioners’ confidence in approaching pancreatic conditions, strengthen their clinical reasoning, and clarify their role in the early detection and long-term management of pancreatic conditions.

Pancreatic conditions often present first in general practice. These include acute and chronic pancreatitis, incidental pancreatic cysts, exocrine pancreatic insufficiency and type 3c diabetes. Patients with concerns about a family history of pancreatic cancer also often present to general practice. Many of these conditions overlap, carry long-term health risks and can be difficult to recognise in early stages.

Pancreatic cancer is the most serious of these conditions. It is the third leading cause of cancer death in Australia, with more than 4500 people diagnosed each year. Survival rates remain low, largely due to late presentation, vague symptoms and the absence of routine screening.

This activity recognises the range of pancreatic presentations seen in general practice. It focuses on practical decision making in primary care, including recognising early signs, managing complications and knowing when to refer. While some areas such as genetic referral and cancer surveillance are less common, they remain important. General practitioners play a key role in identifying at-risk patients, and referral networks are available to support this process.

This activity includes five case studies based on presentations general practitioners are likely to encounter. These include a non-specific abdominal complaint, an incidental pancreatic cyst, follow-up after pancreatitis, management of exocrine pancreatic insufficiency and type 3c diabetes, and assessment of familial cancer risk. Each case outlines key points for assessment, red flags that should prompt escalation and resources to support patient care in general practice.

In completing this activity, general practitioners will build confidence in approaching pancreatic conditions, strengthen their clinical reasoning, and clarify their role in the early detection and long-term management of pancreatic conditions. Links to relevant guidelines and practical tools are included throughout.

Learning outcomes

At the end of this activity, participants will be able to:
  • discuss the assessment and management of patients with incidental and low-risk pancreatic cysts
  • outline the approach to investigating recurrent or chronic pancreatitis in general practice, including associated cancer risk
  • describe the diagnosis and long-term management of pancreatic exocrine insufficiency and type 3c diabetes
  • summarise the role of genetic testing, cascade testing and familial cancer services in assessing inherited pancreatic cancer risk
  • identify the symptoms, risk factors and red flags for pancreatic cancer that warrant timely referral and specialist investigation.

Case studies

Below is a list of the case studies found in this month's edition of check. To see how these case studies unfold and gain valuable insights into this month's topic, log into gplearning to complete the course. 
 

Francis, a man aged 66 years, attends your clinic with a 3-week history of increased thirst, frequent urination and intermittent dysuria. He also reports fatigue and mentions that his clothes feel looser, but he has not weighed himself recently.

He has a long-standing history of alcohol use, estimated at 3–4 standard drinks daily for over 30 years, mostly wine. He has had three hospital admissions for acute pancreatitis over the past decade, the most recent being 2 years ago. Between episodes, he has had intermittent bloating and vague upper abdominal discomfort, which he has attributed to ‘eating badly’ or ‘getting older’.

His other past medical history includes hypertension, managed with perindopril. He is not taking any other medications and does not routinely attend for blood tests. There is no known family history of diabetes or cancer. He is a lifelong non-smoker.

On examination, Francis’s BMI is 24 kg/m2. He appears well hydrated, with normal vital signs. His finger-prick capillary glucose is 16.8 mmol/L. There is mild suprapubic tenderness but no flank pain.

Edward, a man aged 60 years, attends your clinic for follow-up after a recent emergency department presentation with renal colic. His pain resolved with conservative management. As part of the emergency work-up, an abdomen CT scan was performed. The scan confirmed left-sided renal calculi but also revealed an incidental pancreatic cyst. Edward has returned today to discuss the findings and next steps.

Katrina, a woman aged 30 years, presents to the emergency department with severe epigastric pain radiating to her back. The pain increased rapidly after eating dinner and is constant. She has been feeling nauseous and vomiting.

Katrina has no history of gallstones and reports only occasional alcohol use. She does not smoke. Her BMI is 26 kg/m2. She takes perindopril for hypertension and simvastatin for hyperlipidaemia.

Blood tests show a lipase level more than three times the upper limit of normal. Abdomen CT scan reveals an enlarged, inflamed pancreas with peripancreatic stranding. Ultrasound reveals a normal gallbladder and biliary tree with no stones.

She is admitted with acute pancreatitis and treated with intravenous fluids, analgesia and bowel rest. After 4 days, her pain settles and she is discharged with instructions to see her general practitioner within 1 week.

Owen, a man aged 65 years, presents with 6 months of bloating, frequent loose stools and 7 kg of unintentional weight loss. His stools are pale, bulky, oily, difficult to flush and malodorous. Symptoms worsen after larger meals, and he avoids eating out because of urgency.

Owen reports fatigue and reduced appetite. There is no rectal bleeding. He occasionally notices undigested food in the stool.

Past history includes type 2 diabetes for 5 years, hypertension and hypercholesterolaemia. His last HbA1c level was 7.5%. He quit smoking 10 years ago after a 20 pack-year history. He drinks 2–3 glasses of wine most evenings. His current medicines include metformin, amlodipine and atorvastatin. Owen has not undergone any previous abdominal surgeries.

On examination, Owen appears thin and tired. His BMI is 23 kg/m2, down from 27 kg/m2 a year ago. He has reduced upper-arm muscle bulk and mild temporal wasting. Oral mucosa is dry and his tongue is red, smooth and swollen. His abdomen is mildly tender without organomegaly or mass.

Rebecca, a woman aged 74 years, attends your clinic to discuss her family’s cancer history. Her daughter, aged 51 years, was recently diagnosed with pancreatic ductal adenocarcinoma. Rebecca is well and asymptomatic but is concerned about the risk for her children and grandchildren.

Rebecca has a history of hypertension and hyperlipidaemia, managed with medication. She does not smoke and drinks alcohol occasionally. She lives independently and is actively involved in caring for her grandchildren.

She has two adult children (aged 48 and 51 years) and four grandchildren (aged between 10 and 23 years).

CPD

This unit of check is approved for 10 hours of CPD activity (2 hours per case). The 10 hours, when completed, including the online questions, comprise 5 hours’ Educational Activities and 5 hours’ Reviewing Performance.
Educational
Activities
5
hours
Measuring
Outcomes
0
hours
Reviewing
Performance
5
hours

Complete check online

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  1. Log into myCPD home page
  2. Select 'Browse' and search for 1579363
  3. Select the course and register

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