CONCLUSION
This case highlights the risks to overlook open occult female pelvic
fractures in the perineal area. Detection becomes more feasible when
features such as the ’free black air bubble sign’ and ’fracture blade
sign’ on CT, and perineal wounds are identified. These signs help
prevent missed diagnoses. Once the diagnosis is confirmed, the necessity
of colostomy arises to prevent fecal contamination of the wound, thereby
averting widespread infection and safeguarding the patient’s life. In
instances of combined MLL injury, immediate considerations for
puncture-negative pressure drainage or incision and drainage, along with
pressure bandaging, should be explored to achieve optimal therapeutic
outcomes.