肝疾患に合併した消化性潰瘍の検討

Abstract

The incidence, gastric juice secretion, serum gastrin level and conversion to intractable peptic ulcer in patients of peptic ulcers complicated with liver diseases were surveyed. Numbers of cases with liver diseases were 579 out of 30480 clinical ones during January 1971 through December 1977 at the departments of internal medicine and 178 out of 2354 autopsied ones in the past 26 years at the department of pathology of Kansai Medical University.The complication incidences of peptic ulcers with liver diseases in clinical cases were 12.1%in inactive chronic hepatitis,10.0% in decompensatory liver cirrhosis and 10.0% in primary liver carcinoma. Those in autopsy cases were 11.2% in liver cirrhosis and 14.0% in primary liver carcinoma. The complication frequency of peptic ulcers was higher in portal liver cirrhosis than in post necrotic liver cirrhosis, not related with the presence or absence of primary liver carcinoma.Serum gastrin levels at fasted resting state were high in decompensatory liver cirrhosis and gastric cancer although it was in the normal range in most of the other diseases. Its level in liver cirrhosis was higher in cases with esophageal varices than those without them.The recurrence of intractable peptic ulcers accompanied with liver dise ases was always observed and it was not related with the decline of liver function. Moreover, no specific findings were observed either with the time interval of the recurrence, nor with the site, size or type of peptic ulcers.