Acute appendicitis with an appendicolith is one of the most common abdominal emergencies in elderly patients and is more likely to progress to gangrene and perforation. This study aimed to analyze the clinical data of patients over 80 years old who underwent emergency appendectomy for acute appendicitis, to explore the clinical significance of appendicoliths, and to improve treatment strategies.

Inclusion Criteria:

• Patients who aged 80 years or older, who received conservative treatment for less than 24 hours before surgery, who had no peri-appendiceal abscess larger than 2 cm in diameter on CT scan, who underwent emergency appendectomy, and who had postoperative pathological confirmation of acute appendicitis.

Exclusion Criteria:

• Patients younger than 80 years, those with malignancies, and those with incomplete clinical or pathological records were excluded from the study.

The patients over 80 years old who underwent emergency appendectomy for acute appendicitis at the Department of Emergency Surgery of Zhongshan Hospital, Fudan University, from January 2016 to March 2023.