Abdominal cocoon is a rare disease with unknown etiology. It is often difficult to identify and difficult to diagnose before surgery. Wernicke's encephalopathy (WE) is a serious neurological syndrome caused by vitamin B1 (thiamine) deficiency. Both of the early clinical manifestations are non-specific, often difficult to identify and difficult to diagnose. This article reports a case of Wernicke's encephalopathy who received total parenteral nutrition after abdominal cocoon surgery, and reported relevant treatment results. This case reminds us that we should pay close attention to the changes in the patient's condition in clinical work, and pay attention to the occurrence of some rare diseases.