[Congenital intrahepatic portacaval anastomosis: analysis of manifested glucose abnormalities]

The authors report a case of a high-flow intrahepatic portacaval shunt due to a congenital venous abnormality. Suspected by digestive echography, the abnormality was confirmed by angiography. A precise analysis of glycoregulation showed an "impaired glucose tolerance", followed by post-stimulative hypoglycemia with persistant hyperinsulinemia and lowering of the C peptide/insulin ratio. These abnormalities seem to be related to the shunt only. This observation appears as an experimental model permitting the appreciation of the disturbances in glucose metabolism related to an intrahepatic shunt without any hepatic cell disorder.