1 CASE PRESENTATION
Patient: Dong Moumou, gender: male, age: 51 years old, admitted to hospital for ”intestinal obstruction” due to ”abdominal bloating for more than 40 years, worsening nausea and vomiting and admitted to hospital for 20 days”. After repeated treatments in the external hospital, abdominal pain improved, but repeated attacks. Physical examination: Vital signs were stable. Normal development, moderate nutrition, step into the ward, take the lead. Abdominal bulge, abdominal breathing, no intestinal and peristaltic waves, soft abdomen, no tenderness in the abdomen, untouched liver, spleen, and kidneys, Murphy’s sign (-), no percussion in the liver area and both kidney areas . Mobile dullness (-), bowel sounds 3 times / min, no abdominal murmur. Auxiliary examination: CT prompts: manifested as small intestine clustering, dilation of lumen, and fluid accumulation. Cocoon-like, ring-shaped low-density fiber envelopes can be seen around the lesions. After enhancement, the envelopes are strengthened. Initial diagnosis: intestinal obstruction, abdominal cocoon disease is possible. Figure 1. Enteroscopy tips: narrowing of the small intestine at the end of the ileum. What was seen during the operation: During the operation, the omentum was missing. During the operation, the small ileum and sigmoid colon of the ileum were surrounded by a gray, smooth, tough and thick fibrous membrane, which looked like a silkworm cocoon. There is also fibrous membrane adhesion between the intestine and the intestine. The small intestine could not be separated. The small intestine of the ileum was resected and intestinal anastomosis was performed. The sigmoid colon was subjected to fibrous membrane resection and intestinal adhesions were loosened. Intraoperative as shown in Figure 2. After the operation, the specimen was broken open and the small intestine enveloped as shown in Figure 3. Postoperative medical examination supports intraoperative diagnosis. The patient recovered well and was discharged smoothly.