Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

Hernia Discussion Forums Hernia Discussion Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

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    • #10510
      RJ
      Member

      I have learned that fat in the inguinal canal is a routine benign finding in male pelvic/abdominal imaging studies and thus apparently does not mean anything in regards to signifying a groin hernia or any other abnormal pathology.

      This raises the question; how is it possible to differentiate normal fat in the inguinal canal, from a small fat containing groin hernia, from a cord lipoma, or from anything else that could be the cause of regional discomfort? Is this only possible to differentiate in surgery?

    • #13092
      Chaunce1234
      Member

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      It’s primarily based on symptoms, history of a bulge, goal of the patient, physical exam and sometimes imaging. And it is not a one size fits all answer. So the answer to your question is that there is commonly fat in the canal, there is often groin discomfort, and sometimes the two are related and sometimes not. That relationship is often very difficult to sort out. The fat however is not dangerous in terms f risk as it would be if there were intestines in the hernia. Hope this helps!

    • #13099
      drtowfigh
      Keymaster

      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.

    • #13779
      UhOh!
      Participant

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      Sorry to dredge up an old thread, but I just started leafing through pages on this site after discovering it recently and it led me to a question about diagnosis: Is it possible to discern between tissue types involved through imaging, and is there any real advantage to doing this? The info in this thread suggests that there may be slight variations in the cause of symptoms, but not necessarily any difference in the outcome.

      I understand, based on answers to my previous questions, that size of the hernia is often telling (the smallest inguinal hernias are usually composed of fat). But is there any way to definitively “take inventory” of the sac and, to that end, know just how large a hole/tear/weakness exists in the musculature and does that provide any useful information from a management/treatment perspective? Thanks.

    • #13781
      Chaunce123
      Member

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      UhOh, this is based on personal experience, I am not not a doctor so take this info with that knowledge:

      – I believe the advantage to knowing contents is mostly about surgical recommendations (timeline, mainly), and for diagnostics pertaining to the more unusual or ambiguous cases. Patient symptoms matter, as does the patient presentation. Most hernias of the groin are obvious, there is little ambiguity about them existing, and the precise contents are often irrelevant if the hernia is asymptomatic, minimally symptomatic, or the procedure is elective. It may impact a watch and wait vs repair recommendation, but if you’re going to have it repaired anyway it probably does not matter whether there’s fat or bowel in there. The sac contents are figured out definitively during surgery, either way, and as far as I know, the repair is usually the same too.

      – Sometimes an Ultrasound can determine the size of a defect, and sometimes ultrasound can determine the contents as well

      – CT and MRI can also sometimes determine what is contained within a hernia defect, because fat, inflammation, intestine, etc, look differently on imaging studies.

      Both of those say “sometimes” because it may depend on who is reading and interpreting the radiology images. I personally have had mixed opinions about the exact same radiology, so the “sometimes” is pertinent to less-than-obvious cases.

      Clear as mud, from a patient perspective anyway … right? :blink: 😆 😆 😆

    • #13783
      UhOh!
      Participant

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      Thanks, this is helpful. My interests in knowing the “contents” and nature of the defect are twofold: Knowing the likelihood of it getting worse (increasing in size; going from fat-only to fat and bowel) as well as the likelihood of complications (too small to strangulate; just small enough to strangulate).

      Per the original question in this thread, is there much difference in the prognosis for a minimally symptomatic hernia with a fat-only sac, fat seeping into the inguinal canal and a cord lipoma (if there really is a difference between these things)?

    • #13788
      UhOh!
      Participant

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      Oh, and one more imaging-related question: If this was a congenital defect, would an abdominal CT I had done about seven years ago (kidney stone) show it? Don’t have the disk so would need to track it down, so I’m curious if it’s even of any diagnostic value.

    • #13840
      drtowfigh
      Keymaster

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      – Size of hernia does not determine need for repair
      – Size of hernia helps determine best technique for repair
      – All hernias increase in size and content over time. It’s unpredictable who and which type of hernia will grow faster.

      UhOh,
      CT 7 yrs ago may indeed show a hernia.

    • #13851
      UhOh!
      Participant

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      Thanks, will try and track it down. It was actually done in your neck of the woods at Westside Medical Imaging; before bothering to request the disk, do they generally produce good imaging? My only other experiences with medical imaging (aside from dental x-rays) have been at research universities, not private practice…

    • #13857
      Chaunce123
      Member

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      Does a laparoscopic repair fix the canal fat or a cord lipoma?

    • #12205
      drtowfigh
      Keymaster

      Fat in Inguinal Canal vs Hernia vs Cord Lipoma?

      The canal fat or sure. If the cord lipoma is contiguous with that, then yes again.

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