Purpose. To show the diagnosis and treatment of post-resection tuberculous empyema with large chest wall defect when the process was complicated by bronchopleural fistula.

Material and methods. The experience of the successful outcome of treatment of chronic post-resection tuberculous empyema on the right with bronchopleural fistula and a large defect of the chest wall is presented.

Results. The patient underwent multi-stage surgical treatment. The postoperative period was uncomplicated. The patient was in a satisfactory condition when examined 4 years after the surgery. He was able to work and transferred to the III group of dispensary registration for tuberculosis.

Conclusion. The thoracostomy is widely used in the treatment of bronchopleural complications. However even if local sanitation is successful the issue of closing the thoracic defect arises. In those cases when the defect of the chest wall is large and cannot be replaced by local tissues, we consider that the plasty of the chest wall defect with a thoracodorsal flap simultaneously with pleuropneumonectomy is shown.