With what condition will gastrografin enema NOT be therapeutically helpful?

A gastrografin enema is a diagnostic and occasionally therapeutic procedure that uses a water-soluble contrast agent to evaluate and treat various gastrointestinal conditions. In cases of Hirschsprung disease, gastrografin enemas are not therapeutically beneficial because this condition involves a congenital absence of nerve cells (ganglia) in the intestinal wall, leading to a lack of peristalsis in the affected segment of the bowel. As a result, the section of the bowel that lacks these nerve cells does not respond appropriately to any form of enema solution.

Therefore, while gastrografin enemas may help in conditions where impaction or obstruction can be alleviated, Hirschsprung disease requires surgical intervention (such as a pull-through procedure) to remove the affected segment of bowel rather than relying on an enema for relief.

In contrast, conditions like intestinal obstruction, meconium ileus, and rectal atresia may benefit from the use of a gastrografin enema to help clear any blockages or to provide a means of contrast for imaging, thus making the procedure relevant in those contexts.