Abdominal sonography examinations include evaluation of solid intra-abdominal organs butdo not routinely include assessment of the colon. The focus of this study was to determine the utility of colonic sonography in addition to abdominal imaging in the prospective evaluation of patients with nonspecific acute or subacute abdominal symptoms. Patients referred for abdominal sonography for investigation of abdominal pain were evaluated by performing routine abdominal sonography followed by a detailed colonic sonographic examination. Final diagnosis was established by a clinical history questionnaire. Twelve colon (46%) or colon-related pathologies were identified, occurring in the cohort of 26 patients with a mean age of 23 years (range, 18'77 years). Sonographic findings included normal colon (n = 13), inflammatory bowel diseases (n = 6), diverticular disease (n = 5), and colon-related ancillary findings (n = 1). The dedicated colon sonographic examination yielded a sensitivity of 91.6%, specificity of 92.8%, positive predictive value of 91.6%, and negative predictive value of 92.8% (P < .17). Integrating the dedicated colon sonographic examination in addition to the routine abdominal sonography identified significant bowel disease and provided additional information regarding causes of patient symptoms. As this is a pilot study, additional prospective studies in larger populations are required to confirm the results and conclusions.