We present a rare case of a patient with spontaneous liver rupture, who was treated with anticoagulant therapy due to pulmonary embolism. The patient was diagnosed in the emergency department with deep vein thrombosis of his left leg and bilateral pulmonary embolism. He was admitted to the medical intensive care unit and low-molecular-weight heparin (enoxaparin) therapy was introduced. After the third dose, the patient started complaining of right shoulder and chest pain, and 3 hours later, when the patient was put in the sitting position, there was sharp drop of blood pressure, the patient lost consciousness, stopped breathing and pulse was impalpable. He was resuscitated for 4 minutes, after which he regained consciousness and complained of pain in the right shoulder, chest and right upper abdominal quadrant. Emergency abdominal ultrasonography showed free fl uid in the abdomen, and computed tomography showed liver hemorrhage and liver capsule rupture. The patient was transferred to the operating theater, where liver hemostasis and perihepatic packing were performed. This case report shows the extent of possible adverse effects of anticoagulant therapy, even in patients with short duration of therapy and with no prior blood clotting disorders. Prompt diagnosis and treatment of spontaneous liver rupture are crucial in favorable resolution of this complication.Prikazujemo slučaj bolesnika kod kojega je došlo do pojave spontane rupture jetre, a koji je bio liječen antikoagulacijskom terapijom zbog plućne embolije. Bolesniku je u hitnoj službi dijagnosticirana duboka venska tromboza lijeve noge te obostrana plućna embolija. Primljen je u Jedinicu intenzivne medicine te je započeto liječenje heparinom niske molekularne mase (enoksaparin). Nakon primljene treće doze bolesnik se počeo žaliti na bolove u desnom ramenu i prsnom košu te je 3 sata nakon toga, nakon postavljanja u sjedeći položaj, došlo do naglog pada tlaka, izgubio je svijest, prestao disati, a puls nije bio palpabilan. Nakon reanimiranja u trajanju od 4 minute došao je svijesti i žalio se na bolove u desnom ramenu, prsnom košu i gornjem desnom kvadrantu trbuha. Učinjenim ultrazvukom abdomena verifi cirana je slobodna tekućina u abdomenu, a kompjutoriziranom tomografi jom krvarenje iz jetre i ruptura jetrene čahure. Hitno je premješten u operacijsku dvoranu gdje je učinjena hemostaza i tamponada jetre. Prikaz ovoga bolesnika ukazuje na opseg mogućih neželjenih učinaka antikoagulacijske terapije, čak i kod bolesnika koji su kratkotrajno na antikoagulacijskoj terapiji i ne boluju od poremećaja zgrušavanja krvi. Pravodobno postavljanje dijagnoze spontane rupture jetre i primjena odgovarajuće terapije ključni su u poželjnom rješavanju navedene komplikacije
