Nicorandil-induced colonic ulceration.

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pharmacology

Background:

• Elderly patients with cardiovascular comorbidities may present with nonspecific gastrointestinal symptoms.
• Weight loss and altered bowel habits can be indicative of serious underlying pathology.

Observation:

• Biopsies showed chronic inflammation and reactive changes, but findings were suspicious for malignancy.
• A multidisciplinary team recommended a laparoscopic right hemicolectomy, which was converted to open surgery due to complications.

Findings:

• Postoperative histology of the resected bowel confirmed chronic inflammation without malignancy.
• The ulceration was attributed to an 8-year history of nicorandil therapy, suggesting nicorandil-induced colonic ulceration.

Implications:

• This case highlights the potential for nicorandil to cause significant gastrointestinal pathology, mimicking malignancy.
• Clinicians should consider drug-induced colonic ulcers in patients with relevant medication history and suspicious endoscopic findings.
• Further research into the mechanisms and prevalence of nicorandil-induced gastrointestinal complications is warranted.