A variety of radiographically demonstrable colon abnormalities associated with pancreatitis are illustrated. Extensive changes of either localized or diffuse inflammation are more common than has generally been appreciated. Localized changes may mimic carcinoma. Transverse colon inflammation secondary to pancreatitis may be appreciated on plain abdominal radiographs and to better advantage with a contrast enema. This pattern is distinctive and suggests a severe underlying pancreatitis. A water soluble contrast enema is recommended if there is any evidence of colon necrosis or fistula. Recognition of all of the changes of pancreatitis may lead to earlier management of the severe complications.