Subhepatic appendicitis mimicking biliary disease: diagnostic pitfalls and laparoscopic management

The subhepatic appendix is a rare anatomical variant, accounting for up to 0.06% of cases of acute appendicitis. Its atypical presentation, low incidence, and nonspecific clinical features pose a significant diagnostic and therapeutic challenge for surgeons. Laparoscopic appendectomy remains the treatment of choice; however, an open approach may be warranted in cases of severe sepsis, perforation, or extensive intra-abdominal adhesions. We present a case series describing the diagnostic and surgical management of subhepatic appendicitis in a tertiary referral center in Mexico City.