The development of the transvaginal technique has allowed for high-res
olution, detailed evaluation of the female pelvis. Although not previo
usly emphasized, gut pathology can also be recognized with this techni
que. We report two cases of sigmoid diverticulitis which were prospect
ively diagnosed using endovaginal sonography. In both patients, pelvic
sonogram was the first imaging study performed for evaluation of nons
pecific abdominal pain.