A 61-year-old woman with chronic renal failure was scheduled for posterior spinal fusion. The duration of surgery was over ten hours and the patient was placed on prone position almost whole period of surgery. Although the surgery was finished without any obvious complications, laboratory examinations revealed marked liver dysfunction the day after the surgery. On the third postoperative day, computed tomography examination strongly suggested the liver infarction. Liver infarction has been considered as a rare complication because of two kinds of blood streams, the hepatic artery and the portal vein, but we should suspect the liver dysfunction from ischemia after the surgery of prolonged prone position.
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