Classics in abdominal radiology: the jumping deer sign

Abstract

The "jumping deer sign" is an ultrasonographic pattern that aids in identifying normal liver anatomy and distinguishing it from pathology. It includes the portal vein (deer's head and body), the gallbladder or cystic duct (tail), and the inferior vena cava (obstacle). This sign helps differentiate portal veins from intrahepatic ducts, crucial for diagnosing conditions like portal hypertension. It also assists in identifying gallbladder pathologies and assessing the IVC for hydration status. The jumping deer sign provides a clear reference for clinicians, improving diagnostic accuracy, especially for those with limited ultrasound experience.

Keywords: Classics in abdominal radiology; Hepatobiliary; Jumping deer; Jumping stag; Liver; Normal anatomy; Radiology signs; Signs; Ultrasound.

Fig. 1

M mode transverse ultrasound of the liver depicting the “jumping deer sign”

Fig. 2

(A) Ultrasound image demonstrating the “jumping deer sign” with overlays to accentuate anatomical structures: red overlay highlighting the body and head of the deer represented by the main portal vein (PV), right portal vein (RPV) and left portal vein (LPV), green overlay representing the cystic duct (CD), and blue overlay delineating the inferior vena cava (IVC). (B) Abdominal ultrasound image featuring the “jumping deer sign” with a brown overlay illustrating the deer (portal vein and cystic duct leading to the gallbladder) leaping over the log (IVC)