The year 2022 was rich in lessons and saw the issuance of many recommendations in hepatology. Indeed, animal and human studies have shown that hepatic steatosis is closely linked to insulin resistance, justifying not only to search for diabetes in patients suffering from hepatic steatosis but also to evaluate the severity of the possible hepatic impairment in diabetic patients. In addition, new recommendations (Baveno VII) were published in 2022 and propose threshold values for hepatic elastometry for the screening of clinically significant portal hypertension in compensated advanced chronic liver disease and its treatment with non-cardioselective beta blockers to prevent the first episode of cirrhotic decompensation. In January 2022, the American Association for the Study of Liver Diseases also published guidelines for the palliative management of patients with decompensated cirrhosis in whom liver transplantation is not indicated. In the area of inflammatory bowel diseases, two new drugs have been added to the therapeutic arsenal for ulcerative colitis in Belgium in 2022: filgotinib and ozanimod. In addition, the first randomized controlled study of comBIOtherapy was carried out: the “VEGA” study. This is the first randomized study to focus on the combination of biologicals in the field of digestive inflammatory diseases. On the other hand, the “SPARE” study investigated a treatment tapering strategy, particularly in patients with Crohn’s disease. Finally, a group of Belgian experts met several times during the years 2021 and 2022 to establish Belgian recommendations for the management of irritable bowel syndrome. The product of this comprehensive work was published in April 2022.

In 2022, three major themes in pediatric cardiology have captured our attention. From fetal life to adolescence, these topics are very varied and thus illustrate the broad field of competence of our team of pediatric cardiologists.

First, despite coarctation of the aorta (CoAo) being one of the most common congenital heart diseases, its prenatal diagnosis remains challenging. Because of the subtlety of the ultrasound signs of CoAo during the morphological examination in the second trimester of pregnancy, screening is difficult. Yet, the prognosis of these patients depends on prompt management in the neonatal period. The development of fetal cardiac MRI and improved knowledge in cardio-genetics tend to improve fetal detection of CoAo.

Second, postural tachycardia syndrome (POTS) affects the quality of life of adolescent patients. Simple indicators such as heart rate and blood pressure during a head-up tilt test have a predictive value regarding treatment efficiency and prognosis in children with POTS. Recently, a new hypothesis has suggested vaccine-induced autoimmune POTS following mRNA COVID-19 vaccination.

Third, postoperative pulmonary hypertension (PH) after correction of congenital heart defects is a serious and potentially lethal complication. In recent years, PH-targeting drugs have been increasingly used in the postoperative setting. The scientific evidence of an improved outcome is discussed in the last part of this manuscript.