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: erythromycin base / adhesive tape / tegaderm attending: chief complaint: abdominal pain, persistent portal vein thrombosis. major surgical or invasive procedure: : portal venography and thrombolysis. : portal venography, mechanical portal vein thrombolysis. : gelfoam embolization of right hepatic artery branch. : cholecystectomy and attempted portal vein thrombectomy. history of present illness: mr. is a 51 year-old male with a history of crohn's disease who was seen in the emergency room at on with right upper quadrant abdominal pain. a ct of the abdomen and pelvis was performed, which demonstrated moderate colonic fecal load as well as a partially obstructing thrombus in the right posterior portal vein, main portal vein, and smv before the portal vein confluence. he was discharged home by the ed and returned again to the ed on . he once again was complaining of right upper quadrant abdominal pain and an ultrasound demonstrated complete portal vein thrombosis. past medical history: -crohn's disease -non-alcoholic steatohepatitis with transaminemia -glucocorticoid associated osteopenia -peri-anal fistula -nephrolithiasis requiring lithotripsy -osteoporosis (spine t-score -3.0) -hypogonadotrophic hypogonadism: treated with clomiphene since and had been taking testosterone supplementation prior -toe fracture and spinal compression fracture -ileocolectomy (at least 20cm of small bowel and possibly equal length of colon) after presenting with an obstruction two years after stopping 6-mp in effort to conceive social history: no etoh, tobacco, or other drug use. family history: no clotting/bleeding disorders. no dvt or pe. physical exam: physical exam on admission: vitals: t 98, hr 105, bp 123/64, rr 16, o2 100ra gen: alert and oriented x3, nad, lying comfortably on gurney; skin and sclerae anicteric cv: rrr, no murmur, neck veins flat resp: cta bilaterally, no respiratory distress abd: well-healed incision c/w previous surgery; soft, nd, +bs; mildly ttp in ruq; negative sign; no fluid wave; liver and spleen not palpable extr: warm, 2+ peripheral pulses bilaterally; calves soft, sign negative physical exam on discharge: vitals: t 97.8, hr 90, bp 134/76, rr 18, 99% o2 on ra. gen: alert, oriented, in nad. cv: rrr, no m/r/g. resp: cta bilaterally. abd: soft, non tender, mildly distended throughout. abdominal incision clean/dry/intact with steri-strips in place. resolving right flank ecchymosis. ext: 1+ peripheral edema bilateral lower extremities, teds in place. 2+ peripheral pulses throughout. pertinent results: 08:30pm blood wbc-11.6* rbc-4.82 hgb-14.5 hct-42.5 mcv-88 mch-30.1 mchc-34.1 rdw-13.3 plt ct-235 05:15pm blood hct-31.6* 07:59pm blood hct-29.4* 02:07am blood wbc-18.1*# rbc-3.85* hgb-11.3* hct-32.3* mcv-84 mch-29.5 mchc-35.1* rdw-13.6 plt ct-163 02:00pm blood wbc-13.9* rbc-3.08* hgb-9.3* hct-25.7* mcv-84 mch-30.3 mchc-36.3* rdw-14.1 plt ct-194 07:18pm blood hct-29.2* 11:59pm blood hct-29.0* plt ct-112* 11:37am blood hct-31.0* 05:54am blood wbc-10.0 rbc-3.84* hgb-11.5* hct-31.9* mcv-83 mch-29.9 mchc-35.9* rdw-15.2 plt ct-154 05:03am blood wbc-9.5 rbc-3.89* hgb-11.4* hct-32.7* mcv-84 mch-29.3 mchc-34.9 rdw-15.4 plt ct-197 03:00am blood pt-13.5* ptt-22.0 inr(pt)-1.2* 02:07am blood pt-15.7* ptt-21.6* inr(pt)-1.4* 02:16pm blood ptt-47.9* 07:59pm blood ptt-79.3* 02:07am blood pt-15.7* ptt-21.6* inr(pt)-1.4* 11:25am blood pt-14.3* ptt-22.0 inr(pt)-1.2* 07:36pm blood pt-13.6* ptt-25.1 inr(pt)-1.2* 05:54am blood pt-12.6 ptt-26.9 inr(pt)-1.1 05:03am blood pt-15.2* ptt-31.7 inr(pt)-1.3* . 05:30am blood pt-28.2* inr(pt)-2.7* = ***inr on discharge*** . 03:00am blood fibrino-533* 02:11am blood fibrino-559* 11:59pm blood fibrino-556*# . hematologic clotting workup laboratory values: 03:00am blood fact v-100 03:00am blood protcfn-85 protsag-92 03:00am blood aca igg-3.9 aca igm-2.8 03:00am blood prothrombin mutation analysis-test: negative . 08:30pm blood glucose-186* urean-15 creat-1.0 na-135 k-4.4 cl-99 hco3-27 angap-13 03:12pm blood glucose-133* urean-20 creat-1.3* na-141 k-5.3* cl-110* hco3-25 angap-11 05:03am blood glucose-107* urean-12 creat-0.7 na-139 k-3.7 cl-106 hco3-25 angap-12 08:30pm blood alt-25 ast-19 ld(ldh)-167 alkphos-85 totbili-0.3 03:12pm blood alt-145* ast-120* ck(cpk)-194 alkphos-41 totbili-1.8* 02:20am blood alt-283* ast-225* alkphos-60 totbili-0.9 03:20am blood alt-209* ast-125* ld(ldh)-281* alkphos-68 totbili-1.3 05:03am blood alt-97* ast-44* alkphos-81 totbili-0.6 03:12pm blood ck-mb-3 ctropnt-<0.01 11:10pm blood ck-mb-6 ctropnt-<0.01 06:14am blood ck-mb-5 ctropnt-<0.01 07:35am blood calcium-8.7 phos-2.9 mg-2.0 03:12pm blood albumin-2.3* calcium-7.9* phos-4.8*# mg-1.8 05:03am blood albumin-2.5* calcium-7.7* phos-2.6* mg-2.0 11:59pm blood hapto-97 11:59pm blood d-dimer-6140* . imaging and interventional radiology: . abdominal us: impression: 1. no flow demonstrated in the main or left portal veins, compatible with thrombosis. right portal vein not visualized and is also likely occluded. 2. echogenic liver, compatible with fatty infiltration; other forms of hepatic cirrhosis/fibrosis cannot be excluded. 3. focal area of fatty sparing adjacent to the gallbladder in the right lobe. 3. no gallstones or evidence of acute cholecystitis. . cta abdomen/pelvis: impression: 1. thrombosis within the splanchnic venous circulation is more extensive with thrombus now seen within the main portal vein, left main portal vein, anterior/posterior branches of the right main portal vein, and throughout much of the smv. the splenic vein, ivc, and hepatic veins remain patent. 2. enhancing soft tissue lesion within the gallbladder fundus could be a polyp or adenomyomatosis. 3. bilateral small renal hypodensities are too small to characterize but statistically are simple cysts. . portal venography: findings: 1. extensive thrombotic occlusion involving the upper smv, main portal vein and right portal vein. 2. partial cavernous transformation of the portal vein. 3. patent splenic vein and inferior mesenteric vein. 4. prominent coronary vein. impression: successful percutaneous transhepatic portal venography and placement of - 5 french infusion catheter for tpa infusion. plan: the patient will return to interventional radiology for repeat venogram and potential mechanical thrombectomy/thrombolysis on the following day. . portal venography: 1. initial portal venography demonstrated substantial lysis of thrombus burden in the main portal vein and in the distal superior mesenteric vein relative to the initial procedure performed on . 2. mechanical thrombectomy and pulse-spray tpa infusion was performed in the main portal vein and distal superior mesenteric vein followed by mechanical thrombectomy in the left portal vein. 3. successful recanalization of the left portal vein by mechanical thrombectomy alone. 4. persistent occlusion of the right portal vein at the conclusion of the procedure. . cta abdomen/pelvis: impression: 1. new large volume of complex fluid within the abdomen is highly concerning for hemoperitoneum given the patient's history of recent mechanical portal venous/smv thrombolysis. there is evidence of several sites of active extravasation involving hepatic segment v. small regions of hyperdense fluid and an associated locule of air within hepatic segment v also reflect hepatic injury. 2. persistent thrombosis of the main portal vein, left main portal vein, and anterior/posterior branches of the right main portal vein. partial occlusion of the smv is also again noted. the splenic vein remains patent. 3. new bilateral pleural effusions with associated compressive atelectasis, right greater than left. 4. unchanged enhancing lesion in the gallbladder fundus measuring 9 x 5 mm could be a polyp or adenomyomatosis, as previously described on recent ct. 5. non-obstructive right renal calculi. . transcatheter embolization: impression: identification of a region of active extravasation at the lateral periphery of segment vi of a branch of the right hepatic artery. successful embolization with gelfoam. . cta abdomen/pelvis: impression: 1. interval extension of a portal venous clot now extending three-fourths of the way to the splenic hilum within the splenic vein. interval re canalization of a small branch of the left portal vein. 2. new areas of heterogeneous enhancement in the segment vi and inferior portion of segment vii concerning for early infarction. 3. moderately high-density fluid around the liver could be postoperative. no areas of active extravasation noted. brief hospital course: on presentation to on , the patient was once again complaining of right upper quadrant abdominal pain, and an ultrasound demonstrated complete portal vein thrombosis (a progression from the thrombosis of the right posterior portal vein and a short segment of the smv seen on his ct abdomen during his recent presentation to the ed for abdominal pain). on ct scan demonstrated a thrombosed portal vein including the main, right and left portal veins and extension of the clot into the superior mesenteric vein. he was anticoagulated and underwent placement of a transhepatic catheter in the portal vein by interventional radiology on with infusion of tpa. on he underwent successful transhepatic percutaneous thrombectomy by interventional radiology with the angiojet and additional tpa. flow was able to be reestablished in the main portal vein, superior mesenteric vein and left portal vein. the right portal vein could not be thrombectomized. postoperatively, he developed hypotension and was found on ct scan to be bleeding from a branch of the right hepatic artery that had been injured at the time of the percutaneous procedure. he was taken again to interventional radiology the morning of , where he underwent embolization of a branch of the right hepatic artery. a ct scan showed a large amount of blood and clot in the abdomen. the ct further demonstrated that the right, left and main portal veins were once again thrombosed with thrombosis of the superior mesenteric vein as well. therefore the patient was brought to the operating room for evacuation of the intra-abdominal blood and hematoma with attempt at open portal vein thrombectomy on . a large amount of old blood and clots were then removed. since the porta was quite deep and foreshortened, the gallbladder was removed for better exposure. a dissection to identify the portal vein was attempted, however due to extensive collaterals and few viable planes, the attempt at portal vein thrombectomy was abandoned due to the risk of proceeding. hemostasis was obtained, and surgicel was used superiorly and inferiorly. the patient returned to the icu postoperatively, off his heparin drip and intubated. while in the icu his hematocrit was stabilized with multiple units of blood products. a postoperative cta abdomen showed no areas of active extravasation. his heparin drip was restarted on , he was successfully extubated, and transferred to the floor. warfarin was begun on , for a goal inr of . his heparin drip was discontinued , and he was begun on enoxaparin 80 mg twice a day. enoxaparin teaching was provided, which the patient received well. on discharge his inr was therapeutic at 2.7. he was discharged home on warfarin and enoxaparin. his enoxaparin and warfarin dosages on discharge were appropriately titrated, and follow up labs were arranged, which the patient will fax to dr. office for further titration and management of his anticoagulation regimen going forward. his pain medications were transitioned from iv to oral when the patient was tolerating a regular diet. on discharge he was in minimal pain, and was ambulating independently, tolerating a regular diet. . while inpatient, the patient was followed by the gastroenterology service given his history of crohn's disease, and also was seen by the hematology service to asses the cause of his portal vein thrombosis. his home clomiphene and forteo were held given their association with clotting, and a hypercoagulability workup was sent, which was entirely negative at the time of discharge (see labs above). he will follow up with hematology as an outpatient for potential further hematologic testing to determine the underlying cause of his clotting. medications on admission: humira 40mg every other week, clomiphene citrate 50mg qd, vitamin d2 50,000 u tablet once a week, lunesta 3mg qhs, viagra 100mg prn, teriparatide 20mcg sq qhs, tumeric, ursodiol 1500mg once a day, align, mvi, omega-3 fatty acids discharge medications: 1. acetaminophen 500 mg tablet sig: one (1) tablet po q8h (every 8 hours). 2. humira 40 mg/0.8 ml kit sig: one (1) dose subcutaneous every 2 weeks: resume on sunday . 3. vitamin d 400 unit capsule sig: one (1) capsule po once a day. 4. ursodiol 500 mg tablet sig: three (3) tablet po at bedtime. 5. lunesta 3 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. hydromorphone 2 mg tablet sig: one (1) tablet po every four (4) hours as needed for pain. disp:*30 tablet(s)* refills:*0* 8. enoxaparin 80 mg/0.8 ml syringe sig: one (1) syringe subcutaneous (2 times a day): use evening of only. disp:*10 syringes* refills:*0* 9. warfarin 1 mg tablet sig: five (5) tablet po once a day: take at same time in early evening. disp:*150 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: portal vein thrombus with extension to the smv. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call dr office at for fever, chills, increased abdominal pain. monitor for signs of elevated inr from coumadin to include nosebleed, rectal bleeding, dark/tarry stool, easy bruising, bleeding that won't stop. . have labs drawn on monday . have results faxed to dr office at . dr office will follow up with you regarding any dosage changes and time for next blood draw. . no heavy lifting greater than 10 pounds until notified you may do so. for now, walking is your best exercise. timeline for increasing intensity of exercise is dependent on your progress. walking is an excellent exercise for now and is highly encouraged. . no driving if taking narcotic pain medication you may shower, allow water to run over incision and pat area dry. no lotions or creams to incision area. avoid green/leafy , multi-vitamin with vitamin k in it. these foods and vitamin k can alter and bind your coumadin leaving you with a lower inr and increased risk of clot extension. followup instructions: labs at building outpatient lab friday labs at building saturday at 8 am .... provider: , md , ; phone: date/time: 10:20 ... provider: , md, phd , , phone: date/time: 2:00 ... 11:00a , i. sc clinical ctr, hematology/oncology-sc ... provider: . phone: date/time: 1:20 md, procedure: venous catheterization, not elsewhere classified injection or infusion of thrombolytic agent injection or infusion of thrombolytic agent exploratory laparotomy cholecystectomy arteriography of other intra-abdominal arteries other endovascular procedures on other vessels suture of artery phlebography of the portal venous system using contrast material irrigation of vascular catheter central venous catheter placement with guidance diagnoses: other iatrogenic hypotension long-term (current) use of steroids accidental puncture or laceration during a procedure, not elsewhere classified constipation, unspecified accidental cut, puncture, perforation or hemorrhage during other specified medical care acute vascular insufficiency of intestine precipitous drop in hematocrit disorder of bone and cartilage, unspecified other chronic nonalcoholic liver disease regional enteritis of small intestine with large intestine portal vein thrombosis abdominal pain, right upper quadrant anal fistula personal history of pathologic fracture other anterior pituitary disorders 

Answer: The patient is high likely exposed to