Appendicitis threatened to disrupt plans for a dream holiday vacation and a lead role in the school musical for 12-year-old Aria Gibson from Reynoldsburg, Ohio. Two weeks before Christmas, Aria was diagnosed with appendicitis. The condition, caused by a bacterial infection in the appendix, is the most common reason for emergency abdominal surgery for children, sending more than 80,000 young people to the operating room each year.
Aria's mother, Aubrey, knew surgery and the recovery time meant her daughter could not perform in the upcoming school musical. Surgery also had financial implications for the family. Aria's parents had saved for years for a family vacation to Disney World.
They were planning a Christmas Day surprise but were within a two-week window that made the trip non-refundable. "I kept thinking, ‘Oh my goodness, this is not good timing,'" says Aubrey. While the what-if scenarios were worrisome, Aria's health was the family's main concern.
An alternative to surgery
The family went to the emergency department at Nationwide Children's Hospital in Columbus, Ohio, where researchers were conducting the first study in the U.S. to compare outcomes between children who are treated with antibiotics for uncomplicated appendicitis and those who underwent traditional surgery to remove the appendix. Doctors and researchers discussed the options with Aria and her family: surgery to remove her appendix or take IV antibiotics in the hospital for at least 24 hours followed by oral antibiotics for 10 days.
"The doctors talked to me in a way that I was able to understand," Aria says. "I knew I wanted to take part in the study because anything that's not surgery is better than having surgery." Aubrey says she felt comfortable with their decision to participate in the study because Aria would receive the antibiotics while in the hospital and under supervision.
Just over a day after starting IV antibiotics, there was a noticeable change in Aria. She was no longer in pain and could sit up. For three days, Aria received IV nutrients and hydration in addition to the antibiotics, ensuring she was ready for surgery if her condition changed.
Moving forward and looking back
The antibiotic treatment worked, and Aria avoided surgery. She went back to school within days and made it to the stage for the school play. Aria and her brother were surprised on Christmas when they opened gifts with puzzle pieces to the map of the U.S. wrapped inside. In the last gift, they found the state of Florida with "We're going to Disney World!" written on it. The family left for their dream vacation the next day.
Aria was one of 77 patients researchers enrolled in the study, which ran from October 2012 to October 2013. She was among the 93% of patients who showed improvement within 24 hours. Three other patients underwent an appendectomy when their symptoms didn't resolve, but none of them experienced an appendix rupture.
Now 17 years old, Aria looks back on her experience with many positive thoughts. "At the time, I didn't understand the significance of being involved. Now I know this could become the new standard of care for appendicitis patients, and it was cool to see the inner workings of all of it," she says. "I was able to perform in the musical, and I think it was probably one of the best performances I've done because I was just happy that I was able to be there."