A 17-year-old boy, recently emigrated from Mexico, presented to the pediatric emergency department complaining of a yellow, foul-smelling discharge from the umbilicus. He noticed the drainage 3 days previously while changing out of his shirt, which had been stained yellow over the site of drainage. The following morning he experienced increasingly sharp, intermittent abdominal pain around the site of the discharge, which had increased in quantity. The abdominal pain was located only at the site of drainage and did not radiate to any other location. The pain, however, was worse when he strained to urinate or defecate. As far as the patient recalled, the site of the drainage was clean and the skin was intact 3 days prior to presentation. On the evening the patient presented to the emergency room, he admitted that he had never had this pain or discharge before, and he denied any history of periumbilical trauma or abdominal surgery. He also denied dysuria and hematuria but conceded that he had not had a bowel movement in 2 days. The patient reported no associated nausea, vomiting, diarrhea, rash, or fever. A review of systems was completely unremarkable.