Inflammatory and neoplastic diseases of the colon and rectum are relatively common. Cross-sectional imaging plays an important part in the work-up of patients with these disorders. Diverticulitis, appendicitis, and the inflammatory and infectious colitides are among the commonest causes of acute abdominal pain. Affected patients frequently present with non-specific symptoms and often the first radiologic test that they undergo is computed tomography (CT). By virtue of its ability to directly image pathologic changes in the colon wall, serosa, surrounding mesentery and peritoneum, CT can provide crucial information for accurate diagnosis and prompt management. In patients with perianal fistulas, magnetic resonance imaging (MRI) is the preferred imaging technique, as the combination of high intrinsic contrast resolution and large field of view provides detailed information on the presence and extent of the disease. CT-colonography (CTC) is valuable for the detection of colorectal cancer and adenomatous polyps. For the work-up of patients with rectal cancer, endosonography (EUS) and especially MRI are crucial for management.

This presentation describes the features of these disorders, provides differential diagnostic guidelines and indicates the role of imaging in disease management.

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