{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:05:01Z","timestamp":1787029501441,"version":"build-2736575974"},"reference-count":9,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: The deer horn sign is an ultrasonographic (US) finding suggesting congestive hepatopathy. It is composed of dilated intrahepatic inferior vena cava (IVC) representing the deer\u2019s head and dilated hepatic veins (HVs) representing its horns. Case Presentation: A 72-year-old female patient presented with a one-week history of dull pain in the right upper abdominal quadrant. Her medical records showed that she had previously experienced cardiovascular problems; however, she is without any recent heart failure symptoms. The transabdominal US demonstrated the deer horn sign and hemodynamic changes in the hepatic venous drainage, which is suggestive of congestive hepatopathy. An echocardiogram revealed congestive heart failure with a preserved ejection fraction, mild-to-moderate mitral and tricuspid valve insufficiency, and severe aortic valve stenosis with mild aortic valve insufficiency. Conclusions: The definite diagnosis of heart failure is based on clinical and laboratory features; however, this sign may be helpful for diagnosis in emergency settings.<\/jats:p>","DOI":"10.3390\/reports8020079","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T12:24:18Z","timestamp":1748003058000},"page":"79","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Deer Horn Sign in Congestive Hepatopathy Due to Heart Failure"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4917-9270","authenticated-orcid":false,"given":"Thomas","family":"Ferenc","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0824-4988","authenticated-orcid":false,"given":"Andro","family":"Matkovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Svetec","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4766-386X","authenticated-orcid":false,"given":"Filip","family":"Brki\u0107","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3806-4785","authenticated-orcid":false,"given":"Tomica","family":"Brati\u0107","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitorio","family":"Peri\u0107","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3929-3130","authenticated-orcid":false,"given":"Vinko","family":"Vidjak","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1007\/s00261-018-1877-5","article-title":"Playboy Bunny Sign","volume":"44","author":"Ramanathan","year":"2019","journal-title":"Abdom. Radiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/1754-9485.44_12784","article-title":"Playboy Bunny and Moose Head Sign: Hepatic Veins in Congestive Heart Failure","volume":"62","author":"Xiang","year":"2018","journal-title":"J. Med. Imag. Rad. Onc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"433","DOI":"10.5811\/westjem.2011.2.2226","article-title":"\u201cPlayboy Bunny\u201d Sign of Congestive Heart Failure","volume":"12","author":"Hokama","year":"2011","journal-title":"WestJEM"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1111\/j.1076-7460.2007.04912.x","article-title":"Deer Horn Image in the Liver Associated with Giant Right Atrium","volume":"16","author":"Akdemir","year":"2007","journal-title":"Am. J. Geriatr. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Vijay, J., and Naganur, S. (2023). Bunny Image and Deer Horn Sign in Heart Failure; A Clue Not to Miss!. Heart Fail. J. India, 1.","DOI":"10.4103\/HFJI.HFJI_3_22"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1007\/s00261-017-1387-x","article-title":"Congestive hepatopathy","volume":"43","author":"Wells","year":"2018","journal-title":"Abdom. Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Li, J., Wang, C., Dong, H.W., Qi, J., Rao, C., Li, Q., and He, K. (2025). Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: A retrospective study. Eur. J. Med. Res., 30.","DOI":"10.1186\/s40001-024-02264-x"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"W168","DOI":"10.2214\/AJR.05.0168","article-title":"Budd-Chiari syndrome: Spectrum of imaging findings","volume":"188","author":"Brancatelli","year":"2007","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1016\/j.bbmt.2020.06.016","article-title":"Imaging in Hepatic Veno-Occlusive Disease\/Sinusoidal Obstruction Syndrome","volume":"26","author":"Chan","year":"2020","journal-title":"Biol. Blood Marrow Transplant."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/2\/79\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:39:32Z","timestamp":1760031572000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/2\/79"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["reports8020079"],"URL":"https:\/\/doi.org\/10.3390\/reports8020079","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]}}}