Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

If you have groin symptoms that are carefully evaluated and found to be consistent with a groin hernia AND you have tenderness in the are on exam with or without a bulge AND you have fat in the inguinsl canal, then that is a symptomatic inguinal hernia in my book.

I disagree that fat in the inguinal canal is normal and expected. I believe that is always a hernia. If you’re not symptomatic from it then that is an asymptomatic hernia and there is nothing to do about it. That’s all.