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Alagille syndrome (AS) is an autosomal dominant multisystem disorder which can lead to hepatopathy and the development of focal hepatic lesions. The majority of the hepatic lesions are benign, including regenerative nodules, focal hyperplasia, and adenoma. Hepatocellular carcinoma (HCC) is extremely rare in AS, with very few cases reported in the literature. A 38-year-old man complaining of acute right upper quadrant pain with long-standing diagnosis of Alagille syndrome. On imaging, the patient had a large hepatic mass in the right lobe, with arterial hyperenhancement, washout appearance, and areas of internal hemorrhage. The patient underwent a right hepatectomy and histopathology demonstrated HCC. The patient passed away 3 months after the surgery due to infectious complications. HCC is a rare complication of AS, although rare, it should be considered. This case also emphasizes the need of HCC screening in patients with AS in order to allow an early diagnosis and treatment, which can improve patients’ outcome.

The left hepatic vein (LHV) anomalous drainage into the coronary sinus (CS) is an extremely rare congenital vascular abnormality. It is usually asymptomatic, but it has surgical implications if the patient undergoes cardiac, vascular or hepatic procedures. We report a case of a 90-year-old man who had an isolated LHV anomalous drainage diagnosed on a computed tomography performed to evaluate fatigue. The diagnosis of LHV drainage into the CS during preoperative evaluation can avoid intraoperative complications and may determine the preferred surgical approach.

Intestinal malformations are common disorders in newborn and favorable outcomes have been reported for such conditions. Although, if the patient is treated in a not experienced center, misinterpretation of the clinical and radiological findings may lead to errors in treatment and possible complications in adulthood. We report a case of a congenital megaduodenum which was misinterpreted as an intestinal malrotation resulting in late complications. The patient underwent a successful surgical resection of the duodenum with improvement of his clinical symptoms and nutritional status.This case report emphasizes the importance of considering megaduodenum in the differential diagnosis of patients with feeding impairment, even during adulthood. Early diagnosis and treatment may improve patients’ outcome and reduce morbidity. Keywords: Duodenum, Congenital Malformation, Multislice computed tomography