Recently, a little girl with abdominal pain was admitted to our hospital. She presented with abdominal pain for 2 days and came to our hospital after conservative treatment in other hospitals failed. The child presented with persistent periumbilical pain and visited several hospitals. The parents attached more importance to TCM treatment and found me through a friend after conservative treatment with drip and Chinese medicine. Ultrasound did not show any abnormality. In view of the ineffectiveness of conservative treatment for 2 days, we decided to operate after communicating with the parents, and the right adnexa was found to be twisted and necrotic during the operation. Although the patient was finally discharged from the hospital, we deeply regret that: 1. if the patient had been treated surgically earlier, could the right adnexa have been preserved; 2. most hospitals do not do routine ultrasound examination of the small son’s uterus and adnexa because they are small; for patients with abdominal pain, clinicians and ultrasound physicians should strengthen communication and carry out ultrasound examination of the small son’s uterus and adnexa to detect problems at an early stage. I have the following experience from this case: for patients with suspected appendicitis in little girls, it is important to pay high attention to the presence or absence of right-sided adnexal problems, so that the condition of the child cannot be delayed, otherwise it will be regretted for life. As we know, with the progress of medicine, the emergence of effective drugs and the increase of parents’ personal insistence on conservative treatment, more and more pediatric appendicitis patients are cured by conservative treatment. This may neglect the occurrence of other serious conditions, which will be too late once they occur (as in this case). So I think that for little girls when considering appendicitis, the right adnexal problem must be considered (this is less of a problem in adults because it is easier to check the uterine adnexa with ultrasound in adults), and in view of the immaturity of ultrasound examination of pediatric adnexa, so earlier surgical treatment should be advocated, not to wait for surgery when conservative treatment is ineffective (at the same time, also in appendicitis, early appendicitis is usually without peritonitis and pus in the abdominal cavity. In addition, the majority of appendicitis patients have pus in the abdominal cavity at a certain stage of development or when conservative treatment is ineffective.) And once appendicitis is diagnosed, even if it is cured by conservative treatment, there is still a greater chance of recurrence in the future when work and study are stressful (such as before important exams, etc.) and when the weather changes in spring and autumn, so I personally recommend active surgical treatment (of course, surgical treatment may also have certain complications, and if it is cured without surgery and does not recur in the future, non-surgical treatment is the best choice, but this is rare), but of course We will respect the patient’s choice and inform the patient of the possible risks based on the respect of his choice.