INTRODUCTION: Between the infective pancolitis, Clostridium Difficile infections are more common in hospitalized patients. Most of the cases can be resolved with medical treatment but in some patients is necessary to perform a surgical intervention. METHODS AND MATERIALS: In the period between January and September 2018 we diagnosed four different cases of pancolitis due to Clostridium Difficile infection. We considered positive for pancolitis an abdominal CT exam with the presence of at least two different signs between increased intestinal wall thickness, target sign, pericolic fat stranding, bowel or peritoneal pneumatosis RESULTS: All patients have been hospitalized for different reasons, in all of them the CT diagnoses a pancolitis that is regressed in three of four patients with medical treatment and got worse in one case concluding in exitus for the impossibility to undergo a surgical treatment CONCLUSIONS: Abdomen CT with intravenous contrast media is very useful for the detection and follow-up of a colonic involvement in patients with Clostridium Difficile infection. colonic involvement in patients with Clostridium Difficile infection.