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Sonography is an instrumental investigation rarely adopted to determine intestinal occlusion, either for “gassy” patients, or for uncommon establishment of its role, providing additional information in subjects suspected of small bowel obstruction. Intestinal hernia is difficult to be identified, first of all strangulation, especially for unusual localization, excepted inguinal region; natural hystory, especially referred surgery, and clinical examination can be supported by US in emergency, non invasive, not-expensive, portable and reproducing imagin procedure, detecting early complications, such as strangulation and volvolus, with 95% of sensitivity and 82% of specificity, referring to skilled operator. Surgical trained physician or surgeon himself offer the best diagnostic recruitment for ecographic accuracy.