Surgical treatment by PAIR is indicated in the following condition:

• Echinococciosis is also known as hydatid disease. • Hydatid cyst is a parasitic infection of humans by the tapeworm of genus echinococcus. • Echinococcus granulosus causes Cystic Echinococcuosis. • Echinococcus multilocularis causes Alveolar Echinococcuosis. • Echinococcus vogeli causes Polycystic disease. • Echinococcus granulosus: The liver is the most common organ affected followed by lungs, muscles, bones and kidneys. Flushing and urticaria occur in rupture of hydatid cyst. 1. Abdominal tenderness is the most common sign. 2. Tender hepatomegaly signifies secondary infection of the cyst. • Echinococciosis is caused by larval stages of parasite. • Man is an accidental intermediate host. The dog is the definitive host. • Serological assay (Weinberg reaction) is specific example of Complement fixation test used in detection • Detachment of cysts and their collapse leads to characteristic: Water Lilly sign or floating membrane sign • Other X-ray signs of echinococcus are: • Serpent sign/Rising sun sign • Crumbled egg appearance.