Hello and welcome to HCM, Fatty liver and perforated gastric / duodenal ulcer can both cause pain in upper abdomen. An ultrasound of abdomen especially upper abdomen is required to assess the status of abdominal organs. A history of ulcer can lead to recurrence of ulcer in stomach or duodenum. Perforation of ulcer is unlikely because perforation causes very severe pain generalized to whole abdomen. Fatty liver can recur if one is exposed to factors causing fatty liver. Thus, consult your physician for clinical assessment, relevant investigations and thus management. Thanks and take care Dr Shailja Puri