The level of ligation of the GV and ureter has significant impact on the incidence of orchialgia. Ipsilateral testicular pain in patients with left-sided LDN is preventable, if the ureter and GV are ligated or clipped above the level of iliac vessels bifurcation.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide with an estimated 500,000 to 1 million new cases per year. Current study was designed to assess sensitivity of 128-slice CT in detection of small hepatocellular carcinoma in comparison to ultrasound and also to determine the value of equilibrium phase (delayed phase) in diagnosing small hepatocellular carcinoma. Material and Methods: As per these guidelines all the patients underwent ultrasound and serum AFP levels as the initial screening modality. Despite the absence of lesion on ultrasound, patients in whom there was a strong clinical suspicion of HCC in view of AFP levels in the diagnostic range (> 400 NG/ML) or serial raise in AFP levels but less than the diagnostic range underwent CT; and if the lesion size (on CT) ranged from 1 to 2 cm they underwent MRI. Results: Our study group consists of 32 patients with small HCC. Age of the patients ranged from 45 to 76 years with mean age of 63 years. 30 out of 32 patients in our study were male. The number of patients without any etiological factors was 15.The number of patients who were alcoholic are 12, and the number of patients who were positive for HEP-B sag are 3, and the number of patients who were positive for HEP-C sag were 2. The number of patients who were having AFP less than 20 was 16, between 20-200 was 10, between 200-400 was 3, and more than 400 was 3. Conclusion: MDCT is a superior tool for diagnosing small HCC and to identify the multifocal nature of HCC in comparison to US. MRI is a second level imaging modality and should be used in lesions with equivocal findings on CT or when the lesion size is less than 2 cm in size.Arterial phase is mandatory, and delayed phase helps in detecting more lesions than portal venous phase alone.