Patient Safety in Surgery

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Open Access Case report

Rectal ulceration caused by the anti-anginal nicorandil: Case report of a preventable complication

Sachin Malde1* and Ajay Wilson2

Author Affiliations

1 Department of Urology, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9LT, UK

2 Department of Surgery, Stepping Hill Hospital, Poplar Grove, Stockport, SK2 7JE, UK

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Patient Safety in Surgery 2010, 4:10 doi:10.1186/1754-9493-4-10

Published: 30 June 2010

Abstract

The association of the anti-anginal drug nicorandil with oral and anal ulceration is becoming more widely recognised, but there are no reports of isolated nicorandil-induced rectal ulceration. Awareness of this condition is poor, and patients often undergo unnecessary surgery for a condition which resolves on stopping the medication.

We report a case of nicorandil-induced rectal ulceration causing rectal bleeding. The patient was spared surgery after awareness of the link with this drug.

This diagnosis should be considered in patients with unexplained gastrointestinal ulceration after exclusion of serious underlying causes. We hope this report will increase awareness amongst physicians and surgeons of this reversible condition.