We report a case of diversion rectocolitis, an inflammatory process that frequently develops in the distal blind colorectum, after surgical diversion of the fecal stream. Since the endoscopic and histologic findings closely resemble those of inflammatory bowel disease, the differential diagnosis can be difficult. However, the inflammation permanently resolves after surgical reanastomosis. Because diversion colitis can also be treated effectively by local application of short-chain fatty acids, it has been postulated that a local nutritional deficiency, resulting from the absence of these acids, triggers the inflammation.