The superior mesenteric artery (SMA) syndrome is a rare cause of intestinal obstruction. However, conditions associated with rapid weight loss, including malignancy, burns, bariatric surgery, and trauma, can precipitate the syndrome. Recognition of the syndrome requires a high index of suspicion and a multidisciplinary approach in conjunction with the radiologist. Here, we present the case of a patient with metastatic colon cancer, who developed symptoms of abdominal pain and hematuria after undergoing a local ablative procedure for liver metastases. He was extensively evaluated, in view of a history of abdominal pain in the supine position and relieved in the prone position, along with a history of similar complaints following an earlier colectomy procedure and a history of weight loss. In view of this unusual symptom complex coupled with the radiologic findings on the ultrasound, he underwent a barium …