Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: heparin agents / fish product derivatives attending: chief complaint: bowel obstruction major surgical or invasive procedure: exploratory laparotomy, biopsy of omental mass suspicious for metastases, mobilization of hepatic flexure of the colon, and decompressing loop transverse colostomy. history of present illness: mr. is an 83-year-old gentleman who presented with a bowel obstruction. workup with a cat scan demonstrated a mass in the pancreatic body and tail extending to the splenic flexure and involving the splenic artery with apparent thrombosis of the splenic vein. the patient was admitted and treated with nonoperative management initially. however, he failed to improve. he was additionally placed on total parenteral nutrition. because he was not improving, the decision was made to proceed with exploratory laparotomy and bowel diversion. past medical history: htn dvt & pe () s/p ivc ) filter hit several benign colon polyps physical exam: vital signs: his temperature is 99.7, pulse is 60, blood pressure 197/91, respirations are 24, and his room air saturation is 93%. general: he is alert and oriented, in no acute distress. heent: pupils are equal, round, and reactive to light. sclerae are anicteric. neck: supple without jugular venous distention, bruits, or lymphadenopathy. lymphatics: there are no supraclavicular nodes or axillary nodes. heart: regular without murmurs, rubs, or gallops. lungs: clear to auscultation bilaterally. abdomen: soft, distended, with normal active bowel sounds. it is somewhat tympanitic in the right and left upper quadrants. there is no tenderness or appreciable masses. rectal: exam demonstrates no mass. it is guaiac negative. there are no prostatic nodules apparent. extremities: without clubbing, cyanosis, or edema. neurologic: nonfocal. pertinent results: laboratory data: sodium of 131, potassium of 4.2, creatinine of 1.4, bicarbonate of 22, bun of 26, and glucose 265. his complete blood cell count is within normal limits. his inr is 3.4 currently. amylase is 35. alkaline phosphatase and liver function tests are within normal limits as is bilirubin. lipase is 68. his cea is 35, which is elevated (reference 0-4). a cat scan performed on , demonstrates omental thickening, which is concerning for metastatic disease. he similarly has a fullness of the pancreatic body, which extends to the splenic flexure concerning for pancreatic mass or cancer. the splenic vein is not visualized, which is concerning for thrombosis. the splenic artery is encased by the mass measuring 4.3 cm. there is a small amount of perihepatic fluid. he does have what appears to be a transition point at the splenic flexure with dilated proximal colon and small intestine. the chest portion of the ct demonstrates several subcentimeter nodules in the right middle lobe as well as the right lower lobe and in the lingula. brief hospital course: pt. was admitted to on following complaints of crampy abdominal pain. after confirmatory studies, patient was found to have a mass within the body/tail of the pancreas extending to the splenic flexure with partial obstruction of the colon at the splenic flexure, occlusion of the splenic vein and severe narrowing of the smv. these findings were consistent with pancreatic cancer. furthermore, soft tissue deposits within the omentum are consistent with peritoneal carcinomatosis. the patient then underwent an exploratory laparotomy, biopsy of omental mass which was suspicious for metastases, mobilization of the hepatic flexure of the colon and decompressing loop transverse colostomy on . during the operation, however, the patient was at times hypotensive into the 80s, requiring fluid resuscitation and intermittent pressures. the decision was made for the anesthesiologist to place a swan-ganz catheter and to have the patient admitted to the intensive care unit with continued endotracheal ventilation. on post-operative day (pod) 1, the patient was in continued need of fluid support but did not require pressors. he was also noted to be in chronic a-fib which resolvd with an amiodarone drip. he was also restarted on tpn. patient was extubated on pod 2 and moved out of the intensive care unit on pod 3. tpn was stopped on pod 4 and was moved to a clear liquid diet. on pod 5, the patient was tolerating clear liquids and was advanced to diet and placed back on all of his oral medications. at this time, the pathology report stated the specimen was well-differentiated metastatic adenocarcinoma and the patient was then placed on coumadin for prophylaxis against cancer-induced clotting diathesis especially given his history of dvt. the patient also had his sliding scale of insulin increased for more rigorous control. on pod 6, oncology was consulted and recommended that he follow-up with dr. in weeks for palliative chemotherapy most likely with gemcitabine. on pod 9 the patient's inr was 2.4. at that time, the patient started complaining of erythematous spots over his abdomen and upper extremities. he was given benadryl with good result. he was then discharged to rehab and skilled nursing center on pod 10 with a hct of 30.9 and an inr of 3.0; ambulating well with assistance, tolerating regular diet and continuing on a sliding scale of insulin. he was asked to follow-up with dr. in general surgery clinic in days. medications on admission: coumadin 2.5mg qd glipizide 5mg metformin 500mg lopressor 25mg discharge medications: 1. warfarin sodium 1 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 2. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. disp:*30 tablet(s)* refills:*1* 3. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. amiodarone hcl 200 mg tablet sig: two (2) tablet po qd (once a day). disp:*60 tablet(s)* refills:*2* 6. glipizide 5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. metformin hcl 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed. disp:*15 capsule(s)* refills:*0* 9. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed) as needed. disp:*qs 1* refills:*4* discharge disposition: extended care facility: rehab center in discharge diagnosis: metastatic adenocarcinoma, well differentiated . discharge condition: good; tolerating oral diet; ambulating with assistance discharge instructions: 1. call surgery clinic if you notice increased pain, bleeding, discharge, redness, or temperature > 101.5 2. you may shower, but avoid soaking wound - cover with dressing during shower followup instructions: 1. follow up in days in surgery clinic for wound check procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances exteriorization of large intestine transfusion of other serum biopsy of peritoneum intra-abdominal manipulation of large intestine diagnoses: other iatrogenic hypotension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation other specified intestinal obstruction other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure personal history of venous thrombosis and embolism secondary malignant neoplasm of retroperitoneum and peritoneum malignant neoplasm of other specified sites of pancreas 

Answer: The patient is high likely exposed to