Buerger disease (thromboangiitis obliterans) is a non-atherosclerotic, vaso-occlusive disorder of small- and medium-sized arteries and veins strongly associated with tobacco use. First reported in 1908 by Buerger, the disease is seen worldwide with an increased incidence in Asia and the Middle East. There is a particularly high incidence in Japan. Buerger disease is typically seen in adult men and infrequently women. The precise mechanism of the disease remains unclear. Trauma, cold, and injury to the digits or limbs can trigger an ischemic episode.

Patients with Buerger disease experience claudication, often intense pain, and/or paresthesias in the hands and feet as well as rest pain. The disease can quickly progress to include skin ulcers and gangrene of the digits. Amputation may be needed. Superficial thrombophlebitis is also seen in Buerger disease. Joint involvement with recurrent arthritic symptoms of the large joints can precede the occlusive phase and make early diagnosis difficult. Intestinal involvement with abdominal pain, diarrhea, and even frank melena may rarely occur. There have been rare case reports of scrotal and penile involvement.