Journal of Trauma and Acute Care Surgery

We are describing a case of blunt abdominal trauma w/pancreatic injury with focus on discrepancy in its radiological and surgical grading of injury, hence altering the patient management.

https://journals.lww.com/jtrauma/citation/2026/03000/blunt_pancreatic_injury__navigating_the_gray_zones.25.aspx

In multiply injured patients with penetrating brain injury, delaying hemorrhage control for CT was linked to higher mortality. Prompt surgery should be considered when feasible.

https://journals.lww.com/jtrauma/abstract/2026/03000/brain_and_body__early_decision_making_and_outcomes.18.aspx

In this international prospective study, most patients survived one year after acute mesenteric ischemia with good quality of life, largely determined by comorbidities.

https://journals.lww.com/jtrauma/abstract/2026/03000/one_year_survival_and_quality_of_life_after_acute.17.aspx

Cutting-edge proteomic analyses have uncovered potential biomediators of hyperfibrinolysis. Fibrinogen gamma’ and golgi casein kinase (FAM20C) emrge as the top proteins associated w/increased HF.

https://journals.lww.com/jtrauma/abstract/2026/03000/thromboinflammatory_mediators_produced_by.16.aspx

Proficiency in REBOA can be achieved after approximately 5 cases for surgeons and 10 for institutions. The short learning curve supports broader adoption to improve trauma care outcomes.

https://journals.lww.com/jtrauma/abstract/2026/03000/five_to_excellence__the_path_to_resuscitative.15.aspx

Evidence does not support routine platelet transfusion to reverse preinjury antiplatelet therapy for mortality or hemorrhage reduction; data quality is low and further study is needed.

https://journals.lww.com/jtrauma/abstract/2026/03000/should_platelet_transfusion_be_used_to_reverse.20.aspx

At our Level 1 trauma center, INTERCEPT Fibrinogen Complex increased fibrinogen use in patients at risk for massive hemorrhage w/earlier use but no change in mortality or transfusion volume.

https://journals.lww.com/jtrauma/fulltext/2026/03000/cryo_on_call__pathogen_reduced_cryoprecipitated.14.aspx

Access to primary care was associated with 20% lower 5-year mortality after severe injury, underscoring its importance in long-term recovery.

https://journals.lww.com/jtrauma/abstract/2026/03000/access_to_primary_care_is_associated_with_improved.13.aspx

Partially occlusive aortic balloons were recently approved to extend occlusion times. In this study, prolonged partial occlusion was associated with worse neurologic outcomes.

https://journals.lww.com/jtrauma/abstract/2026/03000/prolonged_partial_aortic_occlusion_worsens.12.aspx

This retrospective QI study found surgeon-performed TAP blocks reduced opioid use after emergency laparotomy without increasing complications, supporting their safe, opioid-sparing role.

https://journals.lww.com/jtrauma/abstract/2026/03000/utility_of_transversus_abdominis_plane_block_in.11.aspx

Severe trauma impairs bone marrow hematopoiesis and immune function, likely via exosome-mediated signaling. Gene changes indicate disrupted erythropoiesis and stress responses.

https://journals.lww.com/jtrauma/abstract/2026/03000/trauma_induced_alterations_in_bone_marrow_exosome.10.aspx

In a 47-center study of pelvic fracture with shock, PAE was effective, while PPP was reserved for the sickest patients with higher 6-hour mortality. Survival gains in this group are needed.

https://journals.lww.com/jtrauma/abstract/2026/03000/to_pack_or_plug__american_association_for_the.8.aspx

In mild TBI, multiple intracranial hemorrhage subtypes are not associated with worse outcomes than isolated bleeds, supporting use of the modified Brain Injury Guidelines (mBIG) for both.

https://journals.lww.com/jtrauma/abstract/2026/03000/combined_intracranial_hemorrhage_subtypes_should.7.aspx

In nearly 2000 trauma patients, a simplified bedside score (sSOFA) performed similarly to traditional organ dysfunction measures & may improve triage & resource use in low-resource settings.
https://journals.lww.com/jtrauma/fulltext/2026/03000/a_simplified_sequential_organ_failure_assessment.24.aspx

This manuscript is a narrative review of the creation of ACS as a specialty, the concurrent evolution of the ACS fellowship curriculum, & a discussion of future directions and challenges.

https://journals.lww.com/jtrauma/abstract/2026/03000/the_educational_foundation_for_acute_care_surgery_.23.aspx

ECMO shows potential in trauma-related ARDS. In 1,526 patients, it significantly reduced mortality, especially w/VV ECMO. ICU stays were longer, but complication & infection rates were similar.
https://journals.lww.com/jtrauma/abstract/2026/03000/use_of_extracorporeal_membrane_oxygenation_in.21.aspx

This algorithm provides an evidence-based, practical approach to the initial evaluation and management of non-traumatic esophageal perforations presenting in the emergency setting.

https://journals.lww.com/jtrauma/fulltext/2026/03000/evidence_based,_cost_effective_management_of.3.aspx

Intra-thoracic rib fixation exists but is less studied than extra-thoracic systems. Adding VATS to rib fixation, regardless of plate location, may benefit severe chest wall trauma.

https://journals.lww.com/jtrauma/fulltext/2026/03000/intrathoracic_surgical_stabilization_of_rib.2.aspx

Best of Trauma❇️
American Association for the Surgery of Trauma and the World Society of Emergency Surgery (WSES) recommendations for the diagnosis and management of cervical vascular injuries (CVI).

https://journals.lww.com/jtrauma/fulltext/2026/03000/american_association_for_the_surgery_of.22.aspx

❇️Best of Surgical Critical Care❇️

Watch an overview of "Management of older adult emergency general surgery patients in the intensive care unit: What you need to know"

https://journals.lww.com/jtrauma/fulltext/2026/03000/management_of_older_adult_emergency_general.1.aspx

❇️Best of Surgical Critical Care❇️

"Management of older adult emergency general surgery patients in the intensive care unit: What you need to know"

https://journals.lww.com/jtrauma/fulltext/2026/03000/management_of_older_adult_emergency_general.1.aspx

Watch an overview of "Diverting loop ileostomy with antegrade colonic lavage compared with colectomy in Clostridioides difficile colitis: A decade-long propensity score–matched analysis"

https://journals.lww.com/jtrauma/fulltext/2026/03000/diverting_loop_ileostomy_with_antegrade_colonic.6.aspx

❇️Best of EGS❇️

"Diverting loop ileostomy with antegrade colonic lavage compared with colectomy in Clostridioides difficile colitis: A decade-long propensity score–matched analysis"

https://journals.lww.com/jtrauma/fulltext/2026/03000/diverting_loop_ileostomy_with_antegrade_colonic.6.aspx

❇️Best of Basic Sciences❇️

Watch an overview of "Microvesicles in stored human whole blood increase thrombin generation via phosphatidylserine"

https://journals.lww.com/jtrauma/fulltext/2026/03000/microvesicles_in_stored_human_whole_blood_increase.9.aspx

Best of Basic
Stored whole blood develops microvesicle shedding and reduced clotting on viscoelastic testing. Yet thrombin generation rises during storage due to microvesicle phospholipids.
https://journals.lww.com/jtrauma/fulltext/2026/03000/microvesicles_in_stored_human_whole_blood_increase.9.aspx

❇️What You Need to Know❇️

A trusted clinical review series from the JTACS, designed to deliver concise, evidence-based guidance for trauma, emergency general surgery, and surgical critical care.
https://journals.lww.com/jtrauma/pages/collectiondetails.aspx?TopicalCollectionId=18

Machine learning risk prediction may aid acute care surgery decisions, but models vary in rigor, outcomes, and variables, with limited clinical adoption evaluation.

https://journals.lww.com/jtrauma/abstract/2026/02000/augmenting_decision_making_in_acute_care_surgery_.22.aspx

American Association for the Surgery of Trauma and the World Society of Emergency Surgery recommendations for the diagnosis and management of thoracic vascular injuries (TVI).

https://journals.lww.com/jtrauma/fulltext/2026/02000/american_association_for_the_surgery_of.20.aspx

Adolescent trauma patients may be treated in adult or pediatric trauma centers. There is a paucity of data on rehabilitation-focused services between centers. This study finds differences in care

https://journals.lww.com/jtrauma/abstract/2026/02000/disparities_in_provision_of_rehabilitative.19.aspx

Despite ACS COT recommendations, PTSD screening remains low; a two-question verbal pre-screen improves efficiency by reducing PCL-5 use.

https://journals.lww.com/jtrauma/abstract/2026/02000/a_verbal_prescreen_for_intrusive_symptoms_improves.18.aspx