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Abstract Foreign body ingestions are common in children with many being innocuous as they are passed out spontaneously. Rarely are they known to cause complications like perforation, obstruction and fistula formation mostly due to their nature and or due to migration into the adjacent structures. There are anecdotal reports of such migrations in adults however in children the literature is sparse. We hereby report two children with varied presentations due to migrating ingested foreign bodies and discuss their uniqueness. Keywords: Gastrointestinal, foreign body, children, like perforation, obstruction, adjacent structures Introduction Foreign Body (FB) ingestion is common between 6 months and 6 years of age. 80-90% pass out spontaneously, around 10% require endoscopic retrieval while only 1% require open surgery [1] . We hereby report two cases a soft foreign body causing intestinal obstruction and a sharp foreign body causing sub acute appendicitis not reported thus far and discuss the uniqueness of Migrating Gastro Intestinal (GI) foreign bodies. Case 1 1 year 3-month male presented with bilious vomiting for 2 days with no fever, constipation or blood in stools. He had tachycardia, mild abdominal distention and sluggish bowel sounds, with normal systemic examination. Erect Abdominal X-Ray (AXR) showed dilated small bowel loops, multiple air fluid levels and absence of gas in the pelvis. (Figure 1a) Ultrasonography revealed dilated bowel loops with sluggish peristalsis and a 2.6x2.1x2.4cm, well defined cystic structure in the right iliac fossa. With a differential diagnosis of intestinal obstruction due to Meckel’s band and or a duplication cyst, child underwent emergency laparotomy. Abdomen contained feculent fluid, dilated small bowel with a 2.5x2.5cm intraluminal cystic swelling in the ileum, 40 cm proximal to the ileocaecal junction with pin point perforation. (Figure 1b) Nearly 7-8 cm of the unhealthy ileum containing the cyst and perforation was resected, with end-to-end anastomosis. A gelatinous ball was milked out of the resected specimen. (Figure 1c) In retrospect, mother vaguely remembered child playing with water balls a month ago. Post-operative recovery was uneventful. Case 2 A 3year girl presented with accidental ingestion of pin 1.5 months back managed conservatively, with X-Ray then showing foreign body (PIN) in the right iliac fossa. At admission, her vitals were stable, abdomen was soft and non-tender. Repeat X ray (Figure 2a) picked up the foreign body in the same location, confirmed with a computerized tomogram scan as foreign body in the ileum. At Laparotomy, the pin was found extraluminally with one end near the terminal ileum, with no obvious perforation and the pointed end within the lumen of the appendix wrapped with omentum (Figure 2b, 2c). Upon removal, tip of the appendix was inflamed and appendectomy was done. Discussion Most GI foreign bodies remain asymptomatic and pass out spontaneously. Migration, through the GI tract is a norm rather than exception. Symptoms vary depending on size, shape, location of FB and time duration since ingestion [2] .