Inflammatory and Infectious Disease of the Colon

Abstract

Many patients with inflammatory and infectious diseases of the colon present with abdominal pain. CT is now the preferred initial imaging modality for the evaluation of patients who have nonspecific abdominal pain or are suspected of having colonic inflammation. MDCT with optimized intravenous contrast material administration and thin sections including multiplanar reformations can provide accurate information regarding the degree of bowel wall thickening, location and extent of intramural disease, extraluminal extension, and complications of colonic inflammation. Although the final diagnosis of colitis is often based on clinical, laboratory, and colonoscopic findings with biopsy (Table 17.1 and 2), barium enema is still a principal method for the evaluation of mucosal lesions and caliber change of the colon. Specific CT features sometimes help distinguish various types of colitis and assist patient’s management (Table 17.3 and 4). In this chapter, we review various inflammatory and infectious diseases of the colon with emphasis on distinctive findings on MDCT and barium enema that may help narrow the differential diagnosis.