Also, there is no caseous pneumonia or hematogenous spread lesions in the chest X-ray.
For a tuberculosis patient to progress to such severity, these lesions would definitely be very typical. Thus, the possibility of tuberculosis is almost negligible.
Since it's not tuberculosis, then how did the pneumothorax form?
Based on the symptoms described by the patient and the progression of the condition, it can be determined that the patient first experienced mediastinal emphysema, followed by pneumothorax. So where did this air come from?
From this direction of inference, the argument that pneumothorax was caused by the rupture of pulmonary bullae or emphysema can no longer be supported.
Under normal circumstances, the air in pneumothorax definitely comes from the lungs, trachea, bronchi, or esophagus.
Recalling the patient mentioned discomfort when swallowing food initially, before it gradually progressed to chest pain and difficulty breathing.
