Thoracic trauma is rarely managed by major thoracotomy. We report a 61-year-old male patient with pulmonary abscess after severe thoracic trauma, who was managed successfully by major thoracotomy. The patient was injured after a fall from a height of 6 meters. He developed multiple rib fractures with right flail chest, pulmonary contusion, right hemo-pneumothorax, and subcutaneous emphysema. He was intubated and ventilated, and his chest was drainaged. He had been managed with conservative treatment initially. However he developed a pulmonary abscess in the right lung that was unresponsive to CT-guided drainage therapy. The right lower lobectomy was performed on the 23rd day after his injury. His general condition greatly recovered and all the chest drains were removed on the 45th post trauma day. He was discharged from the hospital on the 86th post operative day. He was considered now fully recovered at 7 months after the accident.
