Since the beginning of winter, we have encountered several cases of small intestine gas (hernia) impaction elderly patients, aged between 80 and 85 years old, two of each sex, all four patients were treated by emergency surgery, three recovered and one died of small intestine necrosis and toxic shock. Every time we see such patients, it makes general surgeons and family members distressed. Today we will talk about what is small intestine gas “embedded”, how to treat and how to prevent. 1.What is “small intestine gas”? ”Small bowel pneumonia, also called hernia, is a lump in the abdominal cavity that protrudes to the surface of the body through weak points such as the inguinal canal, umbilicus, and incisional scar, and is medically called a hernia. Since most of them are protruding intestinal tubes, they are soft to the touch and accompanied by a “grunting” sound, so they are jokingly called “small intestine gas” or “hernia”. 2.What is “small intestine gas” intussusception? Small intestine gas protrudes from the weak point of the abdominal wall to the body surface, and the weak point where it protrudes is called “hernia door” or “hernia ring”, which is most common in the navel, inguinal area and abdominal wall incision. When coughing, laughing or abdominal pressure is increased, the small intestine in the stomach is squeezed and protrudes, and the hernia hatch retracts elastically, and then the intestine will be compressed (stuck), which we call “incarcerated hernia”. 3.What are the dangers of an ingrown small intestine? Once the small intestine is stuck by the hernia door, it will lead to intestinal obstruction, and in serious cases, it will lead to intestinal necrosis or intestinal rupture, and the bacteria in the intestine or fecal-like intestinal contents will flow into the abdominal cavity, which will cause diffuse peritonitis, and even toxic shock and death. 4.What are the clinical manifestations of small intestine pneumonia that is “embedded”? Small bowel pneumonia is one of the most common benign diseases in the elderly, usually manifested as recurrent “lumps” in the navel, inguinal canal area or abdominal incision, often protruding in the early stage when standing or coughing, and returning to the abdominal cavity after sitting or lying down, the lumps disappear. In men, inguinal hernias are more common, and in women, femoral and umbilical hernias are more common. When the hernia mass persists or fails to return to the abdominal cavity in the belly button and groin of elderly patients with hernia, accompanied by abdominal pain, nausea and vomiting, gradual enlargement and pain of the mass, or even redness of the mass, it often means that the small intestine is stuck, which is also known as an incarcerated hernia. This means that the condition is serious and needs to go to the hospital immediately for emergency treatment. 5.How to deal with small intestine gas “embolism”? Once the small intestine gas is embedded, it is necessary to go to the emergency hospital urgently. After the doctor makes a clear diagnosis, most patients need emergency surgery to release the small intestine from compression/jamming, and in case of peritonitis, emergency dissection or laparoscopic investigation is needed, and in serious cases, the necrotic intestinal tube needs to be removed. Elderly patients with combined toxic shock are more dangerous and even need to be admitted to the intensive care unit (ICU). 6.How to prevent? In order to prevent “ingrowth” of small bowel gas, (1) to ensure that the small bowel gas/hernia does not protrude, a hernia belt can be used to compress it, but the effect is usually counterproductive if the compression is not appropriate; (2) small bowel gas/hernia is a benign disease that must be surgically “repaired” in order to heal, so timely surgery is necessary before the hernia becomes ingrowth so that it does not become “ingrowth”. The surgery can be done under local anesthesia, laparoscopy or epidural anesthesia; (3) actively improve constipation, prostate enlargement, chronic cough and other diseases that tend to cause increased abdominal pressure. (1) All kinds of small bowel gas in adults need surgical treatment; (2) All kinds of small bowel gas should be treated surgically as early as possible; (3) Don’t believe that small advertisements on the street can cure small bowel gas; (4) Active treatment of diseases that cause increased abdominal pressure, such as constipation, prostatic hyperplasia and ascites, can reduce the chance of small bowel gas “impaction”; (5) Once small bowel gas is impaction, you should go to the emergency hospital as soon as possible. (5) Once the small intestine gas is embedded, the patient should go to the emergency hospital as soon as possible.