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Abstract Purpose This article introduces a novel deep learning approach to substantially improve the accuracy of colon segmentation even with limited data annotation, which enhances the overall effectiveness of the CT colonography pipeline in clinical settings. Methods The proposed approach integrates 3D contextual information via guided sequential episodic training in which a query CT slice is segmented by exploiting its previous labeled CT slice (i.e., support). Segmentation starts by detecting the rectum using a Markov Random Field-based algorithm. Then, supervised sequential episodic training is applied to the remaining slices, while contrastive learning is employed to enhance feature discriminability, thereby improving segmentation accuracy. Results The proposed method, evaluated on 98 abdominal scans of prepped patients, achieved a Dice coefficient of 97.3% and a polyp information preservation accuracy of 98.28%. Statistical analysis, including 95% confidence intervals, underscores the method’s robustness and reliability. Clinically, this high level of accuracy is vital for ensuring the preservation of critical polyp details, which are essential for accurate automatic diagnostic evaluation. The proposed method performs reliably in scenarios with limited annotated data. This is demonstrated by achieving a Dice coefficient of 97.15% when the model was trained on a smaller number of annotated CT scans (e.g., 10 scans) than the testing dataset (e.g., 88 scans). Conclusions The proposed sequential segmentation approach achieves promising results in colon segmentation. A key strength of the method is its ability to generalize effectively, even with limited annotated datasets—a common challenge in medical imaging.