En bloc resection of a large tuberculous abscess using the stain plombage procedure

En bloc resection is highly recommended for treating tuberculous abscess of the chest wall because of possible recurrence due to microscopic residual lesions; however, complete resection is often difficult. We present a case with a large dumbbell-shaped tuberculous abscess that developed inside and outside the thorax. En bloc resection was successfully achieved using intraoperative closed drainage, ablution, and stain solution plombage procedures, which enabled easy identification of the abscess configuration. When the abscess wall was torn, only minimal solution leakage occurred; therefore, contamination of the surgical field was avoided. We report the procedures we devised and discuss treatments for this obstinate disease.