International Journal of Colorectal Disease

, Volume 32, Issue 9, pp 1289–1294 | Cite as

Topic infliximab injection for refractory rectal stenosis in Crohn’s disease: long-term follow-up in two patients

  • Niels TeichEmail author
  • Ingo Wallstabe
  • Ingolf Schiefke
Original Article



TNF blockers are approved for intravenous or subcutaneous systemic therapy of many chronic inflammatory diseases. As it is not possible to achieve a sufficient local clinical improvement through systemic therapy in every patient, diverse approaches of topical therapy using TNF blockers have been investigated in recent years.


In this paper, we report on long-term clinical results of originator infliximab (IFX) injections into symptomatic combined scarring and inflammatory stenoses of the rectum in two patients with Crohn’s disease. Aiming at high tissue IFX levels, 25 mg of IFX was injected into each quadrant of the stenosis after endoscopic balloon dilatation. This off-label treatment was repeated as necessary, depending on the clinical success.


Topic IFX injection after balloon dilation reduced imperative stool pressure, isolated episodes of incontinence and incomplete emptying. Improvement lasted between 4 and 14 weeks in one patient and the treatment was repeated 13 times in the following 6.6 years. In the other patient, the technique was necessary only twice with no symptom recurrence in the subsequent 5.3 years.


Our experience suggests that topic application of a systemically approved anti-TNF substance may be a successful individualized therapy for refractory stenosis of the rectum in patients with Crohn’s disease.


Infliximab Crohn’s disease Rectal stenosis Endoscopic balloon dilation 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. This study had no funding source.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten Leipzig und SchkeuditzLeipzigGermany
  2. 2.Klinikum St. Georg gGmbH, Klinik für Gastroenterologie und HepatologieLeipzigGermany

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