11th January 2024

A 19-year-old tall, slim gentleman presents to the Emergency Department with acute shortness of breath and pleuritic chest pain for the last 3 days.

A 19-year-old tall, slim gentleman presents to the Emergency Department with acute shortness of breath and pleuritic chest pain for the last 3 days. He has been progressively more short of breath, which prompted his attendance at ED.

Investigations: 

Chest x-ray – 3cm left-sided pneumothorax. 

He undergoes a needle aspiration procedure, which drains 2L of air, and his symptoms resolve. A repeat chest x-ray completed 4 weeks later confirms resolution of the pneumothorax, and he is discharged from the respiratory clinic. 

What pathophysiological mechanism most likely explains his presentation? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.