Today we are speaking with Prof Thomas Attard, of the University of Missouri and Children’s Mercy Hospital of Kansas City, Missouri, where he directs gastrointestinal endoscopy services and leads the hereditary gastrointestinal polyposis multidisciplinary clinic. He is from Malta, where he studied medicine, although by far most of his career has been in the United States. At the 2023 ESPGHAN annual meeting in Vienna this May he presented his and his institution’s experience with video-capsule endoscopy in children with Peutz- Jeghers syndrome, in which hamartomatous polyps develop from stomach through large bowel, complicated by intussusception with obstruction of the lumen. A good double handful of interesting observations – particularly that one should not wait till trouble occurs to evaluate these patients endoscopically.