Neimeier classification of gallbladder perforation

Last revised by Dr Luu Hanh on 03 Aug 2021

The classification of gallbladder perforation was proposed by Neimeier and later modified by Anderson et al. in 1987, which at the time of writing (July 2016) remains the most widely accepted classification for gallbladder perforation.

According to this classification, there are three main clinical subtypes. A fourth type is suggested by Anderson et al. 1:

  • type I: acute free perforation
  • type II: subacute pericholecystic abscess
  • type III: chronic cholecystoenteric fistulation
  • type IV: cholecystobiliary fistula formation

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Cases and figures

  • Type I: acute free perforation
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  • Type 2: subacute pericholecystic abscess
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  • Type III: chronic cholecystoenteric fistulation
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