Abdominal cocoon syndrome (ACS) is a rare condition with primary and secondary forms, may cause acute or chronic intestinal obstruction as a result of encasing the abdominal organs with a fibrocollagenous membrane. It is a cause of mechanical obstruction which is hard to diagnose preoperatively. Definitive diagnosis is mostly achieved under laparotomy. Management of the treatment process becomes difficult when it is associated with other abdominal pathologies. In our case; a sixtyfive-year-old woman was operated and diagnosed with ACS and internal herniation. An anastomosis was performed by resecting intestinal loops. But an anastomotic leak was detected. The patient underwent second operation and a stoma was performed. For surgical management of ACS, we recommend avoiding forming an anastomosis when resection of intestinal loops is required. We think that forming a stoma instead of an anastomosis and early nutritional support will be the most appropriate choice in reducing the complication rates.