This study was aimed at evaluating US reliability and sensitivity in identifying inflammatory or neoplastic bowel diseases in symptomatic patients. Two hundred and fifty patients who had been referred to our Unit for double-contrast barium enema of small bowel and colon, underwent panoramic and targeted abdominal US. According to well-known pathological criteria--i.e., intestinal wall thicker than 5 mm, and pseudo-kidney pattern--US had 61.7% sensitivity for inflammatory and neoplastic bowel diseases. The results indicate that US findings negative for intestinal disease are not reliable unless confirmed by contrastographic and endoscopic examinations. However, panoramic US occasionally demonstrated intestinal abnormalities and allowed collateral diseases to be observed in other organs or apparatuses. These abnormalities had been missed at contrastography, and were sometimes responsible for the symptoms the patients complained of. Targeted US emerged as a useful tool for detailing the lesions demonstrated by double-contrast barium enema, especially in case of expansive pathologies (size of the mass and relationship to adjacent organs).