Secondary peritonitis is a significant cause of mortality in Intensive Care Units in less developed countries, often being associated with cases of widespread infection. Some patients develop a protective mechanism that confines intra-abdominal infection and prevents generalized infection. The omentum is an organ rich in immune cells, particularly found in 'Milky spots', playing an active role in the inflammatory process by forming adhesions that help contain the infection. The main objective of this project is to characterize the immunological microenvironment in the context of acute appendicitis, identifying the cellular populations in 'Milky spots' and the cytokines and chemokines involved in controlled intra-abdominal infection. The identification of these inflammatory biomarkers is crucial for the preoperative selection of patients with different immune responses to acute appendicitis, identifying those who require prompt surgical intervention and those who can be treated without surgical intervention. This clinical decision makes the difference between life and death in countries with limited healthcare resources.