Solution: SMA syndrome is an uncommon condition characterized by compression of the third portion of the duodenum between the aorta and superior mesenteric artery (SMA), resulting in complete, or partial obstruction of the duodenum and subsequent gastric emptying issues. This case shows delayed gastric emptying on nucs study and a distinct area of narrowing in the third portion of the duodenum on the UGI, both of which support this diagnosis. On a sagittal CT image, the SMA to aorta angle will be abnormally acute (<25 degrees) and the distance between the aorta and SMA will generally be 8 mm or less. Typical history is a young female with acute weight loss and findings suggestive of gastric outlet obstruction. Scoliosis surgery also puts patients at risk. Conservative treatment is the first step, particularly in patients with acute weight loss as the underlying etiology, but surgery may be required in some cases.