Inguinal hernia is one of the most common conditions in pediatric surgery. Pediatric hiatal hernias are more frequent in boys and are more common on the right side. Most develop within 2 years of age and present as a painless mass that is retractable from the groin to the scrotum. Surgical treatment is required. Etiology】The etiology of inguinal hernia in children includes congenital factors, i.e. unclosed peritoneal sheath, and acquired factors, such as crying, constipation, chronic cough and ascites. Sometimes the unclosed sphincter is in the form of a narrow canal or partially closed, and various types of syringomyelia are formed. [Pathology] The contents of inguinal hernia in pediatric patients are mostly small intestine, and the greater omentum can enter the hernia sac in larger children. The contents of the right hernia can be the cecum and appendix. In girls, the hernia sac may contain ovaries and fallopian tubes. It can be divided into testicular hernia and spermatic hernia. Clinical manifestations】Pediatric hiatal hernia initially presents as a retractable mass. Sometimes it appears at the first cry after birth, and some of them develop in the first few months after birth, most of them occur within 2 years of age. It is usually asymptomatic and may feel swollen and does not hinder activity. The swelling appears or increases when standing, crying or exerting force, and becomes smaller or disappears after lying down or sleeping. The mass can be incorporated into the abdominal cavity by gently squeezing upward with the hand, and a “gurgling” sound can sometimes be heard during the rejection. Pediatric hiatal hernia is prone to entrapment (the mass cannot be retracted by itself) and mostly occurs in infants and children under 2 years of age. The hernia suddenly enlarges and hardens and cannot be retracted, and the child cries a lot. Surgical treatment] Hernia rarely heals spontaneously, and the hernia mass increases with age, and intussusception and ischemia may occur, which should be treated early. The minimum age for surgery is 6 to 12 months if there is no recurrent intussusception. Pre-operative treatment of pre-existing factors of increased abdominal pressure, such as chronic cough, urinary difficulties, constipation, etc., should be performed. The surgical procedure for pediatric hiatal hernia is a high ligation of the hernia sac. It is a less invasive procedure with fewer steps and less impact on the child. The procedure is performed under intravenous or inhalation anesthesia, and postoperative awakening is quick and the child is not left with a horrible memory. As long as the spermatic vessels and vas deferens are protected during the operation, it will not affect the child’s future fertility; on the contrary, if the operation is delayed, the hernia contents often appear to be stuck on the spermatic cord, which may affect the development of the testes and thus the sexual and reproductive functions. Pediatric syringomyelia is usually performed after 12 months of age with high sphincter ligation, and the procedure is similar to that of hiatal hernia, with basically the same preoperative preparation and postoperative treatment. The treatment of incarcerated hernia] If the hernia has been incarcerated for 12 hours or less, it can be reset manually. If the hernia block is violently squeezed by oneself, intestinal damage may occur, which may lead to serious complications such as intestinal rupture, intestinal perforation, peritonitis and infectious shock. After the local tissue edema subsides 2 to 3 days after the reset, surgery can be considered. Closely observe the abdominal changes 24 hours after the resetting. If the resetting fails or the general condition is poor, active preparation for surgery should be made. Postoperative treatment】 Postoperative bed rest for 3-5 days, light diet, keep bowel movement smooth, avoid strenuous crying and strenuous exercise to prevent scrotal edema, hematoma and recurrence of hiatal hernia. In our department, the scrotum is routinely elevated with tape after this surgery to prevent scrotal edema and hematoma. Recurrence of hiatal hernia is an inevitable problem for both doctors and parents, and there is a certain recurrence rate at all levels of hospitals.