It is well known that acute appendicitis, especially acute suppurative appendicitis, acute gangrenous appendicitis and acute appendiceal perforation, requires emergency surgery. However, for patients with chronic abdominal pain and bloating, the diagnosis of chronic appendicitis is made after examination (e.g., CT) reveals appendiceal stones, and the patient feels that the abdominal pain is relieved after using some anti-inflammatory drugs. Do I need surgery? The appendix is a blind hollow organ located in the cecum, about 6-8 cm long and 0.5 cm in diameter; because it is rich in lymphatic follicles, it is prone to inflammation, and because the blood vessels of the appendix are the terminal branches of the ileocecal vessels, the blood supply is relatively insufficient. There are several major pathogenic mechanisms of appendicitis, the most important doctrines being the doctrine of appendiceal lumen obstruction and the doctrine of bacterial infection. These two cause and effect cycles interact with each other and eventually lead to serious consequences, which can develop from simple inflammation to purulent inflammation, appendiceal necrosis (gangrene), or even perforation or abscess formation, or in more severe cases, liver abscess or sepsis. This is where obstruction is often the initiating cause of appendicitis. Appendiceal stones or fecal stones are the culprits that cause obstruction and lead to serious infections! So how do appendiceal stones and fecal stones form? In a normal physiological state, things such as feces that enter the appendix cavity can be automatically discharged into the intestinal cavity, but if the appendix is too long, folded, twisted, etc., what enters the appendix cavity cannot be discharged and mixes with calcium and other substances secreted by the appendix itself, and over time, fecal stones or stones are formed. Stones or fecal stones can be seeds, fibers, etc. from fruits and vegetables, and we have seen grape seeds, coriander seeds, kidney bean seeds and dead roundworms. So what can appendix stones do? The presence of stones for a long time can cause local pathological changes in the appendix: 1) thickening of the appendix wall; 2) narrowing or occlusion of the appendix lumen; 3) spasm of the appendix due to the mechanical stimulation of fecal stones; 4) chronic inflammation of the appendix due to the above stones or fecal stones with bacteria; 5) necrosis and perforation of the appendix wall due to stone compression and impaction, which can lead to peritonitis. We often pick up fecal stones during surgery, and some of them are quite large. Due to the presence of appendicular stones or fecal stones, appendicitis is repeatedly caused, causing abdominal pain, abdominal distension and other uncomfortable symptoms, which we usually refer to as chronic appendicitis. Sometimes the abdominal pain worsens and becomes acute, which is commonly referred to as an acute attack of chronic appendicitis. Since appendicular calculi or fecal stones are the root cause of appendicitis and can cause serious consequences as described above, appendices with fecal stones or calculi should be removed surgically at the first opportunity. This is especially true for girls (facing a future pregnancy in October, if appendicitis occurs, it can be very difficult to handle in terms of medication and surgery), high school students facing entrance exams (having to interrupt exams due to appendicitis recurrence), and ocean-going sailors (appendicitis at sea can be fatal if not treated in time!) ), and even more aggressive surgical removal. We have seen numerous cases of delayed surgery with serious consequences in our clinic!