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A 28-year-old man with vague abdominal pain, low-grade fever, and diarrhea is treated with antibiotics without significant improvement in his symptoms. Several weeks after symptom onset, the patient develops a skin lesion over the abdomen. His temperature is 37.8 C (100 F), blood pressure is 120/70 mm Hg, and pulse is 88/min. On physical examination, the abdomen is mildly distended and tender to palpation. Bowel contents appear to be draining to the surface of the skin in the right lower abdominal quadrant. This patient most likely suffers from which of the following conditions?
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