IJ Radiology
Hydatid disease of the liver is endemic in cattle rearing areas of the world. A variety of treatment options are available in its management. The common treatment options are medical therapy, surgery and puncture-aspiration-injection-reaspiration (PAIR) therapy.
This study was performed to evaluate the effectiveness of PAIR therapy in the treatment of hepatic hydatid disease.
This cross sectional study was carried out on 15 consecutive patients (Male: 2, Female: 13; Age group: 11-80 years) with hepatic hydatid disease and were treated by PAIR therapy and followed up for a period of 1 year. The cysts were punctured under local anesthesia with an 18G needle using sonographic guidance. Betadine (10% povidone iodine + 1% free iodine) was used as scolicidal agent and allowed to act for 30 min. Cysts larger than 5 cm (n = 5) were drained using an 8F pig tail catheter. The therapeutic response was studied by assessing the reduction in the cyst size, progressive solidification of the cyst, calcification of the wall and increase in the echogenicity of the cyst with pseudomass appearance on serial ultrasound examinations performed on the next day, after 1 month, at 3 months, 6 months and 1 year after the procedure.
Ten patients (66.7%) had Gharbi type I cysts, two (13.3%) had type II and three (20%) had type III cysts. All the patients (100%) showed reduction in cyst size over a 3-6 month period. Pseudomass appearance with solidification was seen in 73% of the patients and calcification was seen in 46.6%. None of the patients developed anaphylaxis, recurrence or peritoneal seedlings. Pain at the injection site was the most common complication observed.
PAIR therapy is an effective minimally invasive treatment for Gharbi type I-III hepatic hydatid cysts. It is a cost effective and safe procedure with significant reduction in the duration of hospital stay.
© 2013, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.
Duman E, Cifci E, Yildirim E. Treatment of Intra-Abdominal Hydatid Cyst Using Modified PAIR Technique: Single Center Experiences. I J Radiol. 2017;14(3):e13645. doi: https://doi.org/10.5812/iranjradiol.13645
Aghaei A, Mohamadi S, Divanbeigi A. Laparoscopic surgery of hepatic hydatid cyst: A case report. J Inflamm Dis. 2024;17(1):e155748. doi:
Rafiei A, Pipelzadeh MH, Jahanshahi A, Erfanian Salim MR. Comparing the Effectiveness of Albendazole and Combination of Albendazole and Praziquantel in Experimental Hydatidosis. Arch Clin Infect Dis. 2009;4(1):. doi:
Geramizadeh B, Baghernezhad M. Hepatic Alveolar Hydatid Cyst: A Brief Review of Published Cases from Iran in the Last 20 Years. Hepat Mon. 2016;16(10):e58744. doi: https://doi.org/10.5812/hepatmon.38920
Heydari S, Taherpour S, Abbasimoghaddam A, Tavakoli Kareshk A. A Pulmonary Hydatid Cyst with Left Lung Involvement: A Case Report. Mod Care J. 2019;16(4):e95196. doi: https://doi.org/10.5812/modernc.95196
Ordering Reprints
Articles are published under the Creative Commons license stated on each article. No permission or royalty fee is required for uses permitted by that license. CCC handles optional bulk and customized reprint orders. Any quotation covers production and delivery services only, not copyright permission. > Request Reprints from CCC
Author(s):
