Pediatric inguinal hernia (indirect inguinalhernia) mostly due to the embryonic testicular descent process of peritoneal sheath failed to occlude due to the neonatal period can be the onset of a congenital disease, is a congenital disease, more common in males, the right side of the left side of the two to three times more, bilateral is rare, one of the common diseases of pediatric surgery. (A) pathogenesis 1, the peritoneal sheath (Nuck tube) failed to atresia degradation is the pathological basis of pediatric inguinal hernia embryo in the fifth week of the testis originated in the middle kidney, is located in the retroperitoneum of the second to third lumbar vertebrae, the eighth week of the testis formation, 12 weeks of degeneration of the middle kidney, the testis with the development of embryonic gradual descent, the twenty-eighth week of testicular band formation, connecting the testis between the lower pole and scrotum, with the band pull and intraperitoneal pressure. With the pulling of the band and the transmission of intra-abdominal pressure, the testis descends and passes through the inner ring of the inguinal canal and the outer ring to the scrotum, and a diverticulum-like tubular protrusion called sheath protrusion protrudes outward from the peritoneum with the descending of the testis at the inner ring, the distal end of the sheath protrusion wraps around the testis to form the testicular intricate sheath in normal conditions; with the testis coming out of the outer ring, the sheath protrusion is also pulled to the scrotum, and after the descent of testis is complete, the sheath protrusion is atresia degenerated. Atresia degeneration, if the sheath is not completely closed, then the formation of hiatal hernia or syringomyelia, girls in the inguinal canal contains round ligament, from the uterus to the labia majora, in the male equivalent of the fetal testis descending, there is also a peritoneal sheath, known as Nuck’s tube; along the round ligament through the inguinal canal descending into the labia majora, the closure is the same as the boys, due to different age, the sheath of the thickness of the sheath varies, the neonatal period is extremely thin. 2, increased intra-abdominal pressure and abdominal wall muscle weakness, etc., is the inguinal hernia promotional factors Some people report that 80% to 90% of newborns born with the peritoneal sheath has not yet closed, the time and mechanism of its closure is not clear, but the incidence of hiatal hernia in postnatal newborns is not high, therefore, the existence of sheath is just a basis for the occurrence of inguinal hernia, there are still other triggering factors, such as increased intra-abdominal pressure, ascites, the presence of a sheath is the foundation of the inguinal hernia, there are still other triggering factors such as increased pressure, ascites, and the presence of a sheath. Preterm infants with weak abdominal wall muscles, etc., prompting the appearance of inguinal hernia, sometimes after peritoneal dialysis or lateral ventricle abdominal drainage, can make the previously asymptomatic children, produce inguinal hernia or syringomyelia. (B) pathogenesis pediatric inguinal hernia due to abdominal organs into the peritoneal sheath without occlusion, and with the abdominal cavity, so the unoccluded peritoneal sheath is congenital inguinal hernia hernia hernia sac, inguinal hernia hernia hernia sac from the inguinal canal internal mouth, located in the lateral side of the abdominal wall of the lower artery, along the inguinal canal walk, through the abdominal wall, in the spermatic cord in the internal anterior and with the spermatic cord close to the spermatic cord, spermatic cord vascular in the outer side of the vas deferens, and the spermatic cord vasculature The spermatic vessels are on the outside of the vas deferens, and the spermatic vessels are often separated from the vas deferens, so special attention should be paid to this during surgery. In adults, inguinal hernia is the formation of a hernia sac after occlusion of the peritoneal sheaths and peritoneal protrusion, so the hernia sac is relatively loose between the hernia sac and the spermatic cord. The inguinal canal is very short in children, especially in newborns and infants, and is about 1 cm in length. Newborns and infants, the omentum is very short, rarely protruding into the hernia sac, the most common hernia content is the small intestine, newborns and infants, the ileocecal mesentery is still imperfectly fixed, the mobility is larger, the appendix, the appendix can not only be herniated into the right hernia sac, but also can be herniated into the left hernia sac, with the growth of age and the omentum of the development of the omentum, the omentum of the older children can be herniated into the hernia sac, the cecum or the bladder of a small number of children constitute a part of the hernia wall, forming sliding hernia, and the hernia is not a part of the wall, but a part of the wall. In a few children, the cecum or bladder forms part of the wall of the hernia, forming a sliding hernia. Hernia neck is small or the outer ring is relatively narrow incipient hernia or small baby hernia, in the violent crying, paroxysm of coughing led to a sudden rise in intra-abdominal pressure, can push more organs to expand the hernia ring and enter the hernia sac, the intra-abdominal pressure is temporarily lowered, the elasticity of the hernia ring retracted, hernia can not be back in the incarceration of hernia, pediatric inguinal hernia incarceration hernia content with intestinal tube, the incarceration of intestinal obstruction of the signs and symptoms, due to local pain and intestinal colic, the child the more the hernia content to intestinal canal, the more the child the more the hernia content to intestinal tube. Intestinal colic, the more the child cries, intra-abdominal pressure continues to increase, coupled with local pain can be reflexively caused by abdominal wall muscle spasms, aggravate the incarceration, difficult to return, compared to adults; pediatric hernia neck and hernia ring is relatively soft, the abdominal wall muscles and fascial tissues are weak, the inguinal canal is subjected to abdominal muscle pressure is smaller, the elasticity of mesenteric blood vessels is also better, so the intestinal canal strangulation occurs, necrosis of the lesser-known, and the circulation disorders caused by the venous The process of blood circulation obstruction by venous return obstruction, bruising, edema development to intestinal necrosis is relatively slow; the blood circulation of the incarcerated intestinal tube is obstructed, the intestinal tube may appear congestion and edema, flaky bleeding, cyanosis of the intestinal tube, and there is much seepage in the hernia sac, after intestinal strangulation and necrosis, the seepage inside the scrotum is cloudy and bloody, the scrotum is red and swollen, and accompanied with systemic toxicity, the spermatic cord is compressed for a long time, and infarction of obstructing the testicular blood transport may occur, the incidence of which is 10～15%. The incidence of infarction is 10-15%.