{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:59:21Z","timestamp":1778511561652,"version":"3.51.4"},"reference-count":35,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Perforated peptic ulcers are a common surgical emergency and rank among the leading causes of acute peritonitis worldwide. Previous studies have suggested a seasonal pattern in the occurrence of symptomatic perforated peptic ulcers. With the advancement of modern medicine, including the widespread use of proton pump inhibitors, and the effects of climate change, this study aimed to assess potential seasonal variations in the incidence of peptic ulcer perforation in our region. Methods: This retrospective analysis included 104 adult patients (mean age: 61.5 \u00b1 14.7 years) who underwent surgical treatment for peptic ulcer perforation between January 2021 and April 2024. Patients were analyzed by gender, age, risk factors (smoking and alcohol consumption), the location of the perforation (gastric or duodenal), and discharge outcome (survived or deceased). Additionally, cases were categorized by the month and season of the ulcer perforation. Results: Among the 104 patients (mean age 61.5 \u00b1 14.7 years), 68 (65.4%) were male. Gastric and duodenal perforations were nearly equally observed (51% vs. 49%). A statistically significant difference in overall perforation rates by gender was observed (p = 0.009), though not between ulcer sites (p = 0.628 and p = 0.739). The highest number of perforations occurred in July (n = 12), while the lowest occurred in November (n = 4); however, no significant variation was found by month (p = 0.916) or season (p = 0.891), despite a predominance in spring. Comorbidities were present in 60% of patients. Smoking (33.6%) and alcohol use (22.1%) were common. Alcohol abuse was noted in 22.1% of patients and was significantly associated with both gastric (p &lt; 0.001) and duodenal (p &lt; 0.001) perforations, though not with the overall incidence (p = 0.284). Smoking, reported in 33.6% of patients, showed no significant association with the perforation site or overall incidence (p = 0.946). The combination of smoking and alcohol use favored gastric perforations, but without statistical significance (p = 0.157). Conclusions: Alcohol consumption appeared to increase the risk of ulcer perforation, while smoking did not demonstrate a statistically significant association. Although spring exhibited the highest observed incidence of peptic ulcer perforation, seasonal variation did not show a statistically significant difference overall.<\/jats:p>","DOI":"10.3390\/medicina61060945","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T04:32:37Z","timestamp":1747888357000},"page":"945","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective Study"],"prefix":"10.3390","volume":"61","author":[{"given":"Iva","family":"Krajnovi\u0107","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine, University of Split, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1517-720X","authenticated-orcid":false,"given":"Zenon","family":"Pogoreli\u0107","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, University of Split, 21000 Split, Croatia"},{"name":"Department of Pediatric Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva","family":"Peri\u0107","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5693-3406","authenticated-orcid":false,"given":"Marija","family":"\u0106avar","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matija","family":"Bori\u0107","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, University of Split, 21000 Split, Croatia"},{"name":"Department of Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"692","DOI":"10.26574\/maedica.2022.17.3.692","article-title":"A Review on Treatment of Perforated Peptic Ulcer by Minimally Invasive Techniques","volume":"17","author":"Coco","year":"2022","journal-title":"Maedica"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"5137","DOI":"10.1007\/s00464-023-09998-5","article-title":"Perforated peptic ulcer (PPU) treatment: An Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach","volume":"37","author":"Costa","year":"2023","journal-title":"Surg. 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