What's causing this periumbilical pain?

Matt, a 42-year-old lawyer, presents with periumbilical pain and discharge draining from the umbilicus. He first noticed redness and pain one day prior.

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Answer and modified case reproduced with permission from Natsuki C, et al. Man with periumbilical redness and umbilical drainage. Emerg Med J 2022; 23 Mar.

  1. J Pediatr Surg 2003; Aug.