Venous Thrombosis and Tight Underwear

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Abstract
Deep vein thrombosis (DVT) and pulmonary embolus, which may represent one disorder (venous thromboembolism),1 are well-known conditions that result in considerable annual morbidity and mortality. Despite an enormous body of literature regarding the pathophysiology; the advances in diagnosis, treatment, and prophylaxis; and the greater awareness of the disease process, the incidence of DVT continues unabated. The original description by Virchow2 (stasis, intimal injury, and hypercoagulability) remains the cornerstone in the pathogenesis of DVT. I bring to your attention the phenomenon of tight underwear syndrome and its potential relationship to new or recurrent DVT. Overly compressive garments are known to cause abdominal symptoms3,4 as well as reduced sperm production. Undergarments typically contain elastic bands that can constrict the abdomen and groin regions, common sites of thrombosis origination. Two recent patients are representative of the potential adverse impact that tight underwear may have. Report of Cases. Case 1. A

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