We report a case of a teenager with scoliosis and pectus excavatum who developed intraoperative refractory hypotension associated with
prone position during posterior surgical correction of scoliosis. In this case, it was more difficult for the anesthetists to figure out the
reason leading to severe hypotension when a surgery was partially completed, because there might be many confounding factors during
surgery. Furthermore, TEE was difficult to be considered to be first diagnosis choice when patient have already underwent posterior
spinal fusion surgery, compared to the cases previous reported that the surgery still did not begin.