RT Journal Article
SR Electronic
T1 Distended Bladder Presenting with Altered Mental Status and Venous Obstruction
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 70
OP 73
VO 15
IS 1
A1 Vaughan Washco
A1 Lee Engel
A1 David L. Smith
A1 Ross McCarron
YR 2015
UL http://www.ochsnerjournal.org/content/15/1/70.abstract
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.