### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I went to the ER on Thursday with fever, vomiting , diarrhea and painful navel. My wbc was 19k. They did CT of the abdomen with and without contrast, which showed enlargement of my appendix, but no air-fluid levels or signs of rupture or abscess . Essentially they said my CT was normal. They prescribed Phenergan and sent me on my way. Now two days later my belly button has a small round protrusion on the inside of my belly button. It is in the very center. I normally have an inny . In addition, the area directly behind my belly button is very hard. I continue to run a mild fever, but have not been vomiting. My question is....could the changes to my belly button be related to appendicitis or is it completely separate?

### output:

Hello! Thank you for the query. Finding enlarged appendix with 19k WBC and fever and sending you home is more that risky for you and for the doctor who did this. You obviously may be suffering from appendicitis and the only way to diagnose it is to rule all other possible reasons of such conditions. The lump in your belly button can be an umbilical hernia (if it has gotten stuck, may be causing such symptoms as well, and should be treated right away) or persisted Uranus (this is a connection between urinary bladder and umbilical cord which should disappear). Persisted Uranus gives umbilicus discharge and urinary tract infections. It is advisable for you to go again to the doctor and have abdominal ultrasound with abdominal wall view, full blood work (CRP and WBC will tell either infection is rising or not), abdominal X-ray (stuck hernia can cause intestines obstruction), urinalysis. Hope this will help. Regards.