Interesting ImagesGallbladder Perforation Into the Peritoneal CavityWang, Bing F. AB∗; Yi, Steven DO∗; Keshavamurthy, Jayanth MD∗; Williams, Hadyn MD∗; Pucar, Darko MD, PhD†Author Information From the ∗Department of Radiology and Imaging, Medical College of Georgia at Augusta University, Augusta, GA †Departments of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT. Received for publication April 27, 2020; revision accepted August 20, 2020. Conflicts of interest and sources of funding: none declared. Correspondence to: Darko Pucar, MD, PhD, Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, New Haven, CT 06511. E-mail: [email protected]. Clinical Nuclear Medicine: February 2021 - Volume 46 - Issue 2 - p e84-e85 doi: 10.1097/RLU.0000000000003317 Buy Metrics Abstract Gallbladder perforation is an uncommon but morbid complication of acute cholecystitis with mural ischemia and necrosis. The most common site of perforation is the fundus because of limited blood supply in this region. The Niemeier classification proposed in 1934 remains the criterion standard in grading gallbladder perforation; type 1 is acute with free perforation into the peritoneal cavity, type 2 is subacute with pericholecystic abscess, and type 3 is chronic with cholecystoenteric fistula. We report a challenging case of type 1 gallbladder perforation due to acute acalculous cholecystitis. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.