[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
April 1979

"Lipoma" of the Spermatic Cord: Potential Relationship to Indirect Inguinal Hernia in Adults

Author Affiliations

Department of Surgery Middlesex General Hospital 180 Somerset St New Brunswick, NJ 08903

Arch Surg. 1979;114(4):549-550. doi:10.1001/archsurg.1979.01370280203038

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


In children, indirect inguinal hernia is of congenital origin, and is due to incomplete obliteration of the processus vaginalis. No such cause applies to indirect hernia in middle age, since one cannot assume that a congenitally unobliterated peritoneal protrusion would remain quiescent during young vigorous adulthood only to become symptomatic in middle life.

An indirect hernia in this age group seems almost universally associated with a spermatic cord lipoma and/or other properitoneal fat adherent to the sac. Such fat tissue is easily deformable, and has almost fluid-like characteristics permitting it to insinuate itself into tissue planes. The internal ring is a channel through the transversalis fascia, and the gradual introduction of fat by internal propulsive forces can widen that pathway. Parietal peritoneum can enter the defect under repeated pressure from above, be dragged into the breach by its adherent fatty pseudopodium, or both.

In two studies of recurrent inguinal hernia,

Postlethwait RW:  Causes of recurrence after inguinal herniorrhaphy . Surgery 69:772, 1971.
Berliner S, Burson L, Katz P, et al:  Ther anterior transversalis fascia repair for adult inguinal hernias . Am J Surg 135:633, 1978.Article