**7. Percutaneous treatment**

This therapy is carried out by means of puncture, aspiration, injection of scolicidal agents, and reaspiration of fluid and hydatid membranes (PAIR). The procedure is performed under ultrasonographic guidance in selected cases. This procedure was developed by a Tunisian team in 1986. The WHO recommends this procedure because it is less invasive when compared to surgery, allows a good evacuation of the parasite, reduces the time of hospitalization, and is less expensive. The following guidelines contain indications and contraindications for this procedure (**Tables 3** and **4**) [56]. It is necessary to have anesthesiological support to treat an eventual anaphylaxis crisis due to hydatid fluid spillage while PAIR is performed [57].


**Table 3.** *Indications for PAIR.*


**Table 4.** *Contraindications for PAIR.*
