A case of empyema necessitatis presenting a mass in the retroperitoneal space is reported. Computer tomography preoperatively revealed the transdiaphragmatic abscess with calcified capsule. The operation was performed by means of resection of the abscess together with overlying ribs. Dead space after resection of the lesion was filled up with intercostal muscles. Empyema necessitatis is rare after introduction of antituberculous drugs. However, recognition of this disease is necessary for an appropriate surgical management. Total resection of the abscess followed by filling of the dead space with the intercostal muscles should be considered as a useful alternative method.
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