A Diagnostic Trap: Subhepatic Appendicitis Mimicking Hepatobiliary Disorders

Subhepatic appendicitis is a rare anatomical variant of acute appendicitis that can mimic hepatobiliary or pancreatic pathology, often resulting in diagnostic delays and increased morbidity. We report the case of a 39-year-old woman who presented with acute upper abdominal pain and vomiting, without fever, right lower quadrant tenderness, and other gastrointestinal symptoms. Laboratory findings showed leukocytosis with neutrophilia and lymphopenia, while liver and renal function tests were within normal limits. Abdominal ultrasound was unremarkable; however, contrast-enhanced computed tomography (CT) revealed an acutely inflamed subhepatic appendix. The patient underwent a laparoscopic appendectomy, which confirmed early inflammatory mass formation and full peritoneal coverage of the appendix. Careful dissection of the peritoneum and mesoappendix with cauterization of the appendicular artery was performed successfully. Postoperative recovery was uneventful, and the patient was discharged the following day. This case highlights the diagnostic challenge of subhepatic appendicitis and underscores the pivotal role of CT imaging in identifying atypical presentations. Laparoscopic appendectomy remains a safe and effective therapeutic option, offering rapid recovery and favorable outcomes.