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Unilateral hyperinflation in pediatric patients is primarily associated with pneumothorax. A pneumothorax occurs when air enters the pleural space, leading to a collapse of the lung on the affected side and resultant hyperinflation on the opposite side. The air trapped in the pleural space exerts counter pressure on the lung, causing it to collapse, while the lung on the unaffected side can expand more fully, leading to a visible increase in size on imaging studies such as chest X-rays.

In contrast, atelectasis typically results in an area of lung collapse on the affected side, which does not lead to hyperinflation, but rather a reduction in lung volume. Asthma, while it can cause hyperinflation due to bronchoconstriction and air trapping, is generally bilateral. Bronchiolitis is characterized by inflammation of the small airways in the lungs, leading to wheezing and respiratory distress but not typically unilateral hyperinflation.

Thus, pneumothorax is the primary condition that distinctly results in unilateral hyperinflation in pediatric patients, differentiating it significantly from the other listed conditions.