We thank Dr Simpson for his comments on our recently published paper entitled ‘Tension pneumothorax mimicking giant emphysematous bullae’.1 Based on the literature, Dr Simpson states the use of the terminology ‘tension pneumothorax’ in our study as being inaccurate. He suggests that it should only be applied to positive pressure ventilated patients as only they can develop supra-atmospheric intrapleural pressure during much of the respiratory cycle.

We agree that ‘tension pneumothorax’ is an overquoted terminology in clinics if we strictly consider its physiological definition (supra-atmospheric pressure for much of the respiratory cycle).2 It is, however, generally used as a synonym for ‘expanding pneumothorax’ which …