["Hepatogenic ulcer": theories and facts (author's transl)].

A review of literature is given concerning the incidence, pathogenesis and clinical relevance of peptic ulcer in chronic liver disease. 1. Today there is no doubt about a highly significant incidence of peptic ulcer in chronic liver diseases, especially in cirrhosis of the liver. Therefore it seems reasonable to use the term "hepatogenic ulcer". 2. Assuming a relation between chronic liver disease and peptic ulceration several theories are discussed with regard to the causality and etiology. Most investigators suppose the diseased liver as "primum movens" in peptic ulceration by means of conditioning different ulcerogenic factors. 3. The clinical finding of increased frequency of peptic ulcer in cirrhotics despite of reduced gastric acid output is no contradiction. It can be explained by relative disturbance of the balance between aggressive and protective mechanism, the latter being diminished. Although a dysfunction of gastric mucus is recently assumed, the specific pathogenetic factor is not clear up to now. 4 Nevertheless, there is no doubt about the clinical relevance of this type of ulcer, given by diagnostic and therapeutic problems and pitfalls.