Immediate Laparoscopic Appendectomy Versus Interval Laparoscopic Appendectomy for Early Appendicular Mass

This study compares two standard treatment approaches for patients presenting with an appendicular mass, an inflammatory lump that forms when the appendix becomes severely inflamed and walled off by surrounding abdominal tissues. The traditional treatment involves conservative medical therapy using intravenous antibiotics followed by an elective interval surgery to remove the appendix 6 to 8 weeks later. Alternatively, advances in minimally invasive surgery allow for an immediate keyhole operation (laparoscopic appendectomy) performed during the initial hospital admission. The goal of this study is to evaluate which approach leads to shorter total hospital stays, faster recovery, and fewer complications. Participants will be assigned to one of two treatment groups: * Group A (Immediate Laparoscopic Appendectomy): Participants undergo laparoscopic surgery to remove the appendix within 24 hours of hospital admission. * Group B (Interval Laparoscopic Appendectomy): Participants receive initial intravenous antibiotics in the hospital until symptoms resolve. After discharge, they return 6 to 8 weeks later for elective laparoscopic surgery. Participants in both groups will be monitored throughout their hospital stay and will attend follow-up visits at 1, 3, and 6 months postoperatively to assess recovery, wound healing, and any potential complications.

Inclusion Criteria: * Adults aged 18 years or older * Clinical diagnosis of appendicular mass confirmed by abdominal ultrasonography and/or abdominal CT scan * Presentation within 72 hours of symptom onset * Provision of written informed consent Exclusion Criteria: * Generalized peritonitis or perforation with free intraperitoneal air * Appendicular abscess \> 5 cm not amenable to percutaneous drainage * History of previous abdominal surgeries (contraindication to laparoscopy) * American Society of Anesthesiologists (ASA) physical status classification ≥ IV * Severe shock or sepsis requiring preoperative intensive care unit (ICU) admission * Suspected cecal malignancy or colonic neoplasm * Pregnancy