Diverticulitis in a patient with a 47-year defunctionalized colon.

A patient who had a cecostomy because of a complicated appendicitis at the age of 17 functioned with an excluded colon for 47 years. He was then hospitalized for diverticulitis and left pericolic abscess. After treatment of the abscess by left segmental colectomy and reanastomosis, the cecostomy was closed. Two years later, he presented a normal bowel habit and improvement of his diverticulosis. Rectal manometric study showed that the rectal was normal both before and two years after surgery. Occurrence of diverticular disease in a normally innervated and vascularized, but almost empty, colon presenting with normal mechanical properties is consistent with Burkitt's hypothesis concerning long-term effects of a low residue diet on the gastrointestinal tract.