Neumotórax espontáneo secundario a enfermedad bullosa en paciente joven: reporte de caso clínico

Pulmonary bullous disease, particularly in young patients, represents a diagnostic challenge when associated with spontaneous pneumothorax. The objective of this case report is to present an uncommon clinical scenario of spontaneous pneumothorax secondary to apical bullous disease in a young female patient, without smoking history, and with clinical features suggestive of a connective tissue hereditary disorder such as Ehlers-Danlos syndrome. A 22-year-old woman with severe allergic asthma was admitted with progressive dyspnea, right-sided chest pain, and clinical-radiological evidence of spontaneous pneumothorax. The methodological approach consisted of a retrospective review of the patient’s medical record, imaging studies, surgical interventions, and hospital course. Initial management included pleural drainage without improvement. A right posterolateral thoracotomy was performed with resection of apical bullae and mechanical-chemical pleurodesis. During hospitalization, multidisciplinary evaluation and imaging studies (chest X-ray, thoracic CT scan, and transthoracic echocardiogram) confirmed complicated bullous disease without structural cardiovascular compromise. Histopathological examination showed bullous emphysema, mild interstitial fibrosis, and chronic alveolitis with no evidence of malignancy. Complete clinical resolution was achieved, and the patient was discharged in stable condition with outpatient follow-up by thoracic surgery, pulmonology, and internal medicine. This case highlights the importance of comprehensive evaluation in young patients with persistent dyspnea, the need to consider connective tissue diseases as an underlying etiology, and the value of early surgical management as an effective strategy to prevent recurrence and complications of secondary spontaneous pneumothorax.