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Goh C, Wong SC, Borland C. Persistent orocutaneous and anal fistulae induced by nicorandil: a case report. J Med Case Rep. 2009;3:119doi: 10.1186/1752-1947-3-119.
Goh, C., Wong, S. C., & Borland, C. (2009). Persistent orocutaneous and anal fistulae induced by nicorandil: a case report. Journal of medical case reports, 3119. https://doi.org/10.1186/1752-1947-3-119
Goh, Cyndi, et al. "Persistent orocutaneous and anal fistulae induced by nicorandil: a case report." Journal of medical case reports vol. 3 (2009): 119. doi: https://doi.org/10.1186/1752-1947-3-119
Goh C, Wong SC, Borland C. Persistent orocutaneous and anal fistulae induced by nicorandil: a case report. J Med Case Rep. 2009 Nov 12;3:119. doi: 10.1186/1752-1947-3-119. PMID: 19946537; PMCID: PMC2783060.
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J Med Case Rep. 2009 Nov 12;3:119. doi: 10.1186/1752-1947-3-119.

Persistent orocutaneous and anal fistulae induced by nicorandil: a case report.

Journal of medical case reports

Cyndi Goh, Sally Cy Wong, Colin Borland

Affiliations

  1. Department of Medicine, Hinchingbrooke Hospital, Hinchingbrooke Heath Care NHS Trust, Huntingdon, Cambridgeshire PE29 6NT, UK.

PMID: 19946537 PMCID: PMC2783060 DOI: 10.1186/1752-1947-3-119

Abstract

INTRODUCTION: Although nicorandil is prescribed widely, awareness of its potential to cause serious complications to the gastrointestinal tract mucosa is limited. Whilst nicorandil-induced oral and anal ulceration is well documented in the literature, nicorandil-induced fistulation is not. This is the first report in the literature of a single patient demonstrating simultaneous orocutaneous and anal fistulae during nicorandil therapy. Two separate cases of orocutaneous and anal fistulae associated nicorandil usage have previously been documented in specialist journals.

CASE PRESENTATION: A 71-year-old Caucasian man presented with a 3-year history of concurrent orocutaneous and anal fistulae. He had been exposed to 30 mg twice-daily nicorandil therapy for 4 years. Both fistulae responded poorly to intensive and prolonged conventional treatment but healed promptly on reduction and eventual withdrawal of nicorandil therapy.

CONCLUSION: Management of resistant cases of orocutaneous and anal fistulae in patients on high-dose nicorandil therapy may be impossible without reduction or even withdrawal of nicorandil.

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