Patients commonly present to the primary care provider or the emergency room (ER) with periumbilical pain. This pain may be related to the pathology of the skin, the abdominal wall, or intra-abdominal contents. The majority of uncomplicated presentations related to skin and abdominal wall pathology can be managed in the community or sent to a surgeon for nonurgent review. Certain "red flags" are described below that mandate emergent review in the emergency room or urgent consultation with a surgeon. The range of conditions and the spectrum of severity can be complex, and general notes on various conditions are also included in this chapter.