I. Hernia and syringomyelia 1. Hernia: Occurs in 1-3% of full-term infants, 3-5% of preterm infants, 2:1 on the right: 2:1 on the left, and 15% bilaterally. The male:female ratio is 8:1. The presence of a mass in the groin, scrotum or labia and a reliable history are sufficient for diagnosis, even in cases where the hernia is not visible. 2. What exactly is the difference between a hernia and a syringomyelia: both have inguinal or scrotal swelling, and syringomyelia collects fluid from the sphincter, located in the scrotum. The size of the scrotum can fluctuate throughout the day. It is nontender and transparent. Not aspirable, treatment is firstly observation waiting. 3. Several questions to ask yourself: Does the mass cause pain? Are there any symptoms of infection? Does the child have any new gastrointestinal symptoms? Is there any scrotal swelling? Do you notice any time the pediatrician’s groin is swollen? Answer: Hernia: Is the mass causing pain? (Yes) Are there any symptoms of infection? (sometimes no) Does the pediatrician have any new GI symptoms? (vomiting, little food, nausea, nervousness) Is there only a swelling of the scrotum? (No, inguinal swelling only or both inguinal and scrotal swelling) Did you notice any time the pediatrician had inguinal swelling? (Yes) 4. Surgical management: Open surgery: inguinal approach, key points: freeing the hernia sac, retrieval of hernia contents, high ligation. Emergency surgery: incarcerated hernia. Laparoscopic surgery 5. Points to note for hernia in girls: possible complete androgen insensitivity in children with male karyotype but female phenotype, 1:20,000, inguinal hernia with palpable testes. Second, acute scrotal disease 1, testicular torsion: the main cause of testicular absence, the incidence of 1:4000, more common on the left side. Characterized by: sudden onset of testicular pain and enlargement, which cannot be relieved by itself. Bilateral testicular asymmetry, painful swelling, Prehn’s sign, and absence of levator ani are found. ultrasound diagnosis. Urgent surgery is required. 6-hour window, beyond which there is a high chance of testicular necrosis. 2, torsion of epididymis/ testicular attachment. 3.Epididymitis/ testicular epididymitis. 4.Testicular trauma.