Abdominal cocoon (abdominal cocoon) is a rare abdominal disease, the cause of which is unknown and difficult to diagnose preoperatively. It is characterized by the total or partial cocooning of the small intestine within an abnormal fibrous membrane, and the treatment is mainly surgical. The clinical manifestations of abdominal cocoon disease are diverse, also called small bowel confinement, small bowel cocoon wrapping, primary sclerosing peritonitis, limited small bowel wrapping, idiopathic sclerosing peritonitis, small bowel segmental fibrous wrapping and sugar-coated bowel. Since the wrapped organs are not only the small intestine, but sometimes the colon, uterus and adnexa, and the organs as a whole are extraperitoneal organs, it is more appropriate to call it abdominal cocoon disease. The etiology of abdominal callus is not clear, one includes: 1, congenital anomalies. 2, repeated episodes of inflammation of the abdominal cavity. 3, the influence of drugs. 4, primary peritonitis. There may be a relationship between the higher incidence of abdominal callus in patients with cirrhotic trauma, malignancy and cardiac failure with ascites. Due to foreign body irritation in the abdominal cavity, it causes increased fibrin exudation followed by mechanization to form a fibrous peritoneum. It indicates that the onset of abdominal callus is related to the acute and chronic inflammation of the abdominal cavity caused by the stimulation of abdominal injury, which may be a factor in the pathogenesis of abdominal callus. The patient’s intra-abdominal fibrous membrane is cocoon-like, creamy white or yellowish, with a smooth surface, starting from the flexor ligament, the mesenteric root or the lesser omentum, ending at the middle and lower ileum, the end or the pelvic organs, partially adherent to the anterior abdominal wall, and the subdiaphragmatic space disappears. The thickness of the fibrous membrane was mostly between 1-12 mm, tough and easy to loosen, and multiple intestinal pressure marks were visible on the intestinal surface of the fibrous membrane after loosening. After separation of the loose adhesions between the intestines, the plasma membrane of the small intestine was smooth and the intestinal wall was flexible as usual. The fibrous membrane is partially sclerotic with glass-like lesions, and the interstitial small vessels are congested and dilated with lymphocyte infiltration. The clinical manifestations of abdominal cocooning are as follows: 1. young patients are more frequent, and there is no significant difference in the incidence ratio between men and women; 2. no previous surgical history of unexplained intestinal obstruction or constipation; 3. a history of recurrent abdominal pain, nausea and abdominal distension, but only some patients also have stopped defecation and exhaustion, that is, only some of the clinical manifestations of intestinal obstruction, lacking the four characteristics of typical intestinal obstruction, non-surgical treatment is effective, and sometimes can 4. Some patients show asymptomatic abdominal masses, which are mostly round, slightly moving, and can be compressed, and intestinal sounds can be heard on the surface. Abdominal cocooning is a rare surgical condition with no specific clinical manifestations and can be asymptomatic for life, and is often detected due to intestinal obstruction, abdominal masses or combined with other diseases. Diagnosis Although it has been reported repeatedly in recent years at home and abroad, the lack of standardized clinical diagnostic criteria makes it difficult to diagnose the disease, especially the preoperative diagnosis is rarely confirmed. At least the following points must be met: 1, part or all of the small intestine is wrapped by the fibrous membrane; 2, the fibrous membrane is continuous and intact; 3, the fibrous membrane is an independent structure with separable planes between the wrapped small intestine; 4, the pathological tissue type of the envelope is fibrous; 5, whether the large omentum is absent or not should be used as an auxiliary but not necessary basis for diagnosis. Treatment The treatment of abdominal cocooning is mainly surgical, in principle, complete removal of the peritoneum, release of adhesions and removal of the cystic band. Recently, scholars have advocated that complete excision and extensive separation of the peritoneum need not be pursued deliberately. Although some scholars advocate that abdominal callus should be treated non-operatively as far as possible, this disease often has no obvious symptoms, and is often combined with other diseases with acute onset, and the diagnosis is not clear at the time of admission, and surgical treatment is often performed.