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In the management of small bowel obstruction (SBO), patients with strangulation or bowel necrosis need to be diagnosed and treated urgently. Contrast enhanced ultrasonography (CE-US) is a new modality to visualize small focal lesions and perfusion in solid organs, especially liver. The purpose of this study was to assess the accuracy of CE-US in the diagnosis of strangulation in SBO.We reviewed the medical records of 16 patients with surgically treated strangulation in SBO. In those 16 patients, 11 were performed CE-USpreoperatively. Preoperative CE-US findings and operative findings were investigated retrospectively in 11 patients.Inpreoperative CE-US, five patients were diagnosed as no blood flow (45.5%), four were decreased blood flow (36.4%), and two were positive blood flow (18.2%). In operative findings, nine patients were performed small bowel resection of ischemic or necrosed segment. One patient were performed only separation of adhesion, which resulted to be reperfusion. In two patients, who were diagnosed positive blood flow, ischemic or necrosed intestine was found and small bowel resection was done.In our experience, CE-US showspromising diagnostic value for the strangulation in patients with SBO.