The reason why I wanted to write such a small article on science came from two emergency visits. Once, a two-year-old girl was born with a hernia, but her parents thought it was a minor problem and never sought medical attention. It was not until one day after the hernia had been embedded for 15 hours, the child was in pain and crying that she was seen in our hospital. Another time was a few days ago, I saw a one-and-a-half-year-old boy with an embedded right hiatal hernia no less than ten times, but he was unwilling to undergo surgery. When I asked him why he did not want to operate, the parents said something that was painful and chilling to me. He said, “I’m not going to hide it from you, doctor, but my old man is the director of a big hospital in the city, and he said, “Pediatric hernia is not a big disease, so it’s okay not to operate. I was at a loss when I heard that. What exactly is considered a serious illness? After several examples of persuasion, I finally had to carry out a manual reset as requested by the family and then left. It is true: “I would rather believe in the degree than be confident”. In fact, pediatric hernia is one of the common diseases in pediatric surgery, commonly known as “small hernia”, “small intestine gas”, “gas egg”, “big egg “The pathogenesis is different from that of adults, because during embryonic development, a sac-like protrusion called “sphincter” is created by the peritoneum in the groin (commonly known as the root of the thigh). It is generally atrophied and occluded around the time of birth. During this period, if the child cries a lot, coughs, has constipation and difficulty in defecation, or if there is a tumor or ascites in the abdominal cavity, the abdominal pressure increases, and the organs in the abdominal cavity, such as the intestinal canal, appendix, girl’s ovaries, fallopian tubes, etc., burrow into this sac, which is called “hiatal hernia” in medical science. “This sac is called “hernia sac”. This is the most common type of hernia in children. If the abdominal organ enters the hernia sac and stays for a long time without resetting itself, causing impaired blood circulation to the herniated contents, it is called an “incarcerated hernia”. If the incarceration is prolonged or repeated, it can cause harm to the body, such as ischemic necrosis of the herniated organ. In boys, excessive pressure on the spermatic cord can lead to testicular necrosis; in girls, adhesions and blockage of the fallopian tubes and ischemic necrosis of the ovaries can occur, causing serious damage to the child. This will cause serious damage to the child. Even if the hernia is not embedded, the long-term compression of the spermatic cord by the contents of the hernia will cause impaired blood flow to the testes and reduce the blood supply, thus causing varicose veins in the spermatic cord, testicular stasis, lack of oxygen and eventual atrophy. Moreover, as children grow older and become more active, the falling intestinal canal strains the mesentery, causing not only inconvenience in walking, but also abdominal pain, nausea and other uncomfortable symptoms, and at school, children of the same age will ridicule and even give them nicknames, affecting the psychological development of children. Zhang Yong, General Surgery Department of Shanghai Deji Hospital Generally speaking, for children under six months old, if the hernia sac is large and the contents of the hernia can freely enter and leave the sac, it will not cause serious consequences in the short term and parents can defer surgery without excessive tension; however, if the hernia is frequently incarcerated, it should be taken seriously and operated as soon as possible. Parents should not have excessive illusions and should actively undergo surgery as early as possible to avoid the tragedy described at the beginning of the article. Regarding the treatment, many parents expect it to heal on its own without treatment. In fact, it is possible for a pediatric hiatal hernia to heal on its own, and a few cases of self-healing have been seen clinically, but it is not advisable to wait for self-healing. Ageing, increased activity and the enlargement of the hernia mass will breed the emergence of complications. Therefore, it is now generally accepted at home and abroad that surgery is the best treatment for inguinal hernia. Conservative treatment is the most expected and readily accepted by parents, and some parents even try to induce doctors to provide them with conservative treatment as a once-and-for-all magic formula, such as the use of hernia belts, which is often mentioned by parents. The use of a hernia belt is not without merit, but it is not universal for any patient. It can be tried for infants under six months of age, or for those with other serious medical conditions that are not suitable for surgery, as well as for small hernia sacs that have little chance of developing a hernia mass. However, it is important to use the hernia belt correctly and to observe it regularly, because if the hernia comes out under the belt, the treatment will not be effective. The hernia belt should not be used for too long and it is better to switch to surgery in time for poor results. We have encountered many cases of varicocele and adhesions around the spermatic cord caused by improper use or long time use of hernia belt. Not only the old disease is not cured, but also a new disease is added, and it makes the surgery more difficult. That is “adding frost to the snow and rain to the house”. It is not suitable for repeated use in the same patient. There are strict indications for manual repositioning. Generally, if the time of incarceration is less than ten hours, the patient’s general and local condition is good, manual repositioning can be tried, but it is better to be operated by a professional pediatric surgeon who has been working for more than three years. Embedded for a longer period of time, before the reset can be given the appropriate amount of sedative, antispasmodic drugs. The resetting technique is very skillful, not the average person can master by reading a book. Because of the weakness of the intestinal canal in children, the intestinal wall edema and increased brittleness after the embedment, rough operation is likely to have intestinal rupture, blood in the stool, fever and other adverse consequences, that will be a botched, laughable. Surgery is not an unbearable thing. In regular hospitals specializing in pediatric surgery, the procedure can usually be completed in about thirty minutes, with less than two centimeters of residual scarring and no significant pain to the child. The child can eat, drink and play like a normal child the day after surgery. For safe recovery and to keep parents from worrying, it is perfect to be observed in the hospital for 3-5 days and discharged after wound dressing change. The chance of recurrence after surgery is rare. Of course, laparoscopic surgery can also be used to help detect whether the contralateral sphincter is closed or not, but laparoscopic surgery requires tracheal intubation and longer anesthesia time. Some parents are afraid that the same disorder will appear on the other side after surgery and ask the surgeon to explore the other side at the same time during surgery. Parents often worry that anesthesia may have an effect on the child’s intelligence. In fact, this concern is superfluous. Modern anesthesia techniques are safe and reliable and have minimal effect on human intelligence, not to mention the fact that pediatric hernia surgery is extremely short, with minimal medication, and the effect on intelligence can be said to be “zero”. Imagine how many mentally retarded people there are on the planet if we worry about the 500 million people who receive anesthesia every year worldwide!