PT - JOURNAL ARTICLE AU - Vaughan Washco AU - Lee Engel AU - David L. Smith AU - Ross McCarron TI - Distended Bladder Presenting with Altered Mental Status and Venous Obstruction DP - 2015 Mar 20 TA - Ochsner Journal PG - 70--73 VI - 15 IP - 1 4099 - http://www.ochsnerjournal.org/content/15/1/70.short 4100 - http://www.ochsnerjournal.org/content/15/1/70.full SO - Ochsner J2015 Mar 20; 15 AB - Background New onset or acute worsening of bilateral lower extremity swelling is commonly caused by venous congestion from decompensated heart failure, pulmonary disease, liver dysfunction, or kidney insufficiency. A thromboembolic event, lymphatic obstruction, or even external compression of venous flow can also be the culprit.Case Report We report the case of an 83-year-old male with a history of myelodysplastic syndrome that progressed to acute myeloid leukemia, bipolar disorder, and benign prostatic hypertrophy. He presented with altered mental status and new onset lower extremity edema caused by acute bladder outflow obstruction. Computed tomography of the abdomen and pelvis showed the patient's distended bladder compressing bilateral external iliac veins.Conclusion Insertion of a Foley catheter resulted in several liters of urine output and marked improvement in his lower extremity edema and mental status a few hours later. Our extensive workup failed to reveal a cause of the patient's acute change in mental status, and we attributed it to a concept known as cystocerebral syndrome.