case_images: PMC11801809_01
case_images: Abdominal X-ray showing marked gaseous distension of bowel loops (*), suggestive of bowel obstruction, along with pneumoperitoneum (arrows) (a). Axial abdominal CT scan showing multiple air-fluid levels and distended intestinal loops (*) (b and c).
case_images: cureus-0017-00000077090-i01.jpg
case_images: PMC11801809_01_cureus-0017-00000077090-i01.jpg
case_images: FIG1
case_images: X-ray revealed pneumoperitoneum and multiple air-fluid levels (Figure 1a). Small bowel distension was noted, with loops appearing encapsulated within a thin, contrast-enhanced peritoneal capsule, resembling a cocoon (Figure 1b, 1c).
case_images: Intraoperative images showing a fibrous membrane covering the intestinal loops (arrows) (a). The resected specimen demonstrates significant congestion and hemorrhagic discoloration. The bowel loops appear distended (arrows) (b).
case_images: cureus-0017-00000077090-i02.jpg
case_images: PMC11801809_01_cureus-0017-00000077090-i02.jpg
case_images: FIG2
case_images: Photomicrograph showing granulomatous inflammation with multinucleated giant cells (arrow) and epithelioid macrophages, along with scattered lymphocytes. Areas of caseous necrosis are seen on the right (*) (H&E, x 200).. H&E: hematoxylin and eosin
case_images: cureus-0017-00000077090-i03.jpg
case_images: PMC11801809_01_cureus-0017-00000077090-i03.jpg
case_images: FIG3
case_images: Histomorphological examination of the resected specimen revealed intestinal tuberculosis with a granulomatous reaction and characteristic caseating necrosis (Figure 3).