Diagnostic Dilemma in Pediatric Subhepatic Appendicitis: A Report of Two Cases

Subhepatic appendicitis is a rare anatomical variant of acute appendicitis that is caused by abnormal appendix positioning. It is an uncommon anatomical variation that poses diagnostic difficulties, especially in the pediatric population, where symptoms may be nonspecific. Its unusual presentation frequently results in a delayed diagnosis, increasing the possibility of complications like perforation and abscess formation. We report two pediatric cases of subhepatic appendicitis in previously healthy children aged 7 and 10 years who presented with abdominal pain and vomiting. Ultrasound aids in the diagnosis of these cases. In both of our cases, laparoscopic appendectomy was performed, and the recovery following the procedure was uneventful. These cases demonstrate how difficult it can be to diagnose subhepatic appendicitis in children because of its peculiar presentation, which can resemble gastric or hepatobiliary disorders. We report these cases with the objective of raising awareness among clinicians regarding the possibility of subhepatic appendicitis, particularly in patients with atypical upper abdominal pain, to highlight the signs and symptoms of this rare illness, and to underscore the value of ultrasonography as a diagnostic tool.