DOI: 10.36347/sjmcr.2021.v09i03.008

Pages: 227-230

Introduction: Hydatid cyst is endemic parasitic zoonosis in North Africa, caused by Echinococcus granulosus. The cysts commonly developed in liver. Classically the treatment is based on association of open surgery and oral chemotherapy, but since the mid 1980s a minimally invasive procedure was proposed by a Tunisian team, called PAIR (Puncture, Aspiration, Injection, Re-aspiration). This technique proved its efficacy and safety management of active hydatid cysts. Aims and scope: We report a reinforced variant of this procedure with double aspiration, injection and re-aspiration using initially hypertonic saline serum and secondary absolute alcohol 96%. Material and methods: A retrospective study conducted on 8 patients (10 liver hydatid cysts) collected from the department of interventional radiology between jan-2016 to decem-2020. An 18 needle puncture after local anaesthesia and under sonographic guidance, aspiration of the cyst and subsequent injection aspiration of two protoscolicidal agent: hypertonic saline serum first and then absolute alcohol 96%. Results: All cases were successfully treated, with short hospitalization length. There was no major complication or morbidity. Conclusions: Obviously, this second aspiration-injection, re-aspiration increase efficacy and decrease recurrence probability.