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: thiazides / ace inhibitors / terazosin attending: chief complaint: ampullary adenoma major surgical or invasive procedure: : 1. transduodenal ampullary resection. 2. reimplantation of common bile duct and pancreatic duct. 3. open cholecystectomy with common bile duct exploration. history of present illness: mr. is a 61m who was evaluated to have a pancreatic ductal dilatation and a bulging ampullary mass that showed low-grade dysplasia on biopsy. this was after he developed a vague abdominal pain and a weight loss over the past several months. he had no prior abdominal surgical history, but he has relatively new diagnoses of coronary artery disease that was being evaluated and chronic obstructive pulmonary disease from 50 years of smoking cigarettes. he also drinks a considerable amount. he had mild jaundice, back pain, abdominal pain and weight loss, but no steatorrhea. he is not diabetic. he does not have any chest pains, palpitations. he is on aspirin and which was be held preoperatively. past medical history: past medical history: - cardiac cath - no cad, mild lv dysfunction without mr lvef 45%, non-ischemic cardiomyopathy - stress mibi with abnormal gated scintigraphy. ekg 2mm st depression. occasional pvcs. perfusion abnormaloty with mild anterior wall lv and apex with reversibility. mild global hypokinesis. - hypertension - hyperlipidemia - 50 pack year h/o tobacco abuse - h/o impair fasting glucose - copd - h/o ampullary adenoma with pancreatic ductation dilation - recent 25lb unintentional weight loss since past surgical history: - egd/ercp - right breast nodule excision - transduodenal ampullary resection - open cholecystectomy with common bile duct exploration social history: etoh: rums/d for 30+ years. pt does not endorse problem with tobacco: quit 12 days ago smoked 1.5 ppd for 40+ yrs illicits: prior marijuana, denies cocaine, no ivdu living: in townshend with wife working: worker driving the bus family history: uncle premature cad and death in 50s mother alive, no known heart disease father died from etohism and ?cad brother died from aids sister unknown health status, estranged physical exam: upon discharge: vitals: 98.2, 56, 136/70, 12, 96% ra gen: aao x 3, nad cv: sinus bradycardia resp: ctab, diminished bases b/l abd: bilateral subcostal incision with staples and open to air, moderate erythema around staples line with minimal swelling. right lateral portion open with moist-to-dry dressing and moderate serosanguinous drainage. old jp site with occlusive dressing and c/d/i. ext: warm, no c/c/e pertinent results: 03:13am blood wbc-4.2 rbc-4.19* hgb-13.8* hct-42.0 mcv-100* mch-32.9* mchc-32.8 rdw-14.0 plt ct-210 05:40am blood wbc-9.0 rbc-4.54* hgb-15.4 hct-46.7 mcv-103* mch-33.9* mchc-32.9 rdw-13.7 plt ct-137* 03:13am blood glucose-124* urean-5* creat-0.6 na-142 k-3.8 cl-102 hco3-33* angap-11 pathology examination name birthdate age sex pathology # , 61 male report to: dr. gross description by: dr. . /mtd specimen submitted: gallbladder, ampulla vater. procedure date tissue received report date diagnosed by dr. . /dsj?????? diagnosis: 1. gallbladder, cholecystectomy (a-b): chronic cholecystitis and cholelithiasis. 2. ampulla of vater, resection (c-f): a. adenoma (low-grade dysplasia) involving duodenum with minimal involvement of the ampullary duct; no invasive carcinoma seen. b. cauterized margins free of dysplasia. clinical: ampullary adenoma. brief hospital course: the patient was admitted to the general surgical service for evaluation and treatment. on , the patient underwent transduodenal ampullary resection, which went well without complication (reader referred to the operative note for details). after a brief, uneventful stay in the pacu, the patient arrived on the floor npo, on iv fluids, with a foley catheter, with ciwa protocol in place for alcohol withdrawal, and an epidural for pain control. the patient was hemodynamically stable. on pod#1 (): the epidural was continued for pain control, and the foley catheter was maintained. ivf were continued, and the patient remained npo. due to an episode of questionable chest pain, an ecg, cxr, and cardiac enzymes were obtained, all of which were negative. in the evening, his pain control was split between an epidural and a pca. on pod#2 (): he was continued on ivf, and due to an episode of brief mom unresponsiveness responding well to supplementary oxygen, cardiac enzymes and cxr were repeated, which were once again unremarkable. on this day his epidural was discontinued, but foley catheter was maintained for strict input and output monitoring. on pod#3 (): due to some concern for erythema around his incision, he was placed on iv antibiotics (cefazolin). ivf were continued, and his pca was maintained for pain control. due to severe agitation and signs of withdrawal in the evening, he was transferred to the sicu for further care. on pod#4 (): he continued to display symptoms of withdrawal, for which the ciwa protocol was employed. his foley catheter was maintained, and ivf were continued. on pod#5 (): he had some continued, but improved symptoms of withdrawal and agitation. his foley catheter was maintained, and he was continued on ivf. he remained npo for diet. his pain was controlled with intermittent iv dilaudid. on pod#6 (): patient was transferred on the floor from icu in stable condition. his diet was increased to clears and was well tolerated. small amount of erythema was noticed around incision without any drainage. on pod#7 (): diet increased to full liquids. patient ambulate independently. he was started on iv cefazolin empirically s/t redness around his wound was increased and small fluid collection was palpable on right lateral site of incision. jp drain was removed. on pod#8 (): patient remained afebrile. diet advanced to regular and well tolerated. right lateral aspect of incision was open and moist-to-dry dressing was started, patient will continue to have moist-to-dry dressing at home with vna. the patient was discharged home in stable condition. the patient remained stable from a cardiovascular standpoint; vital signs were routinely monitored. good pulmonary toilet, early ambulation and incentive spirometry were encouraged throughout hospitalization. electrolytes were routinely followed, and repleted when necessary. the patient's white blood count and fever curves were closely watched for signs of infection. wound care was performed regularly and thoroughly. the patient's blood sugar was monitored throughout his stay; insulin dosing was adjusted accordingly. the patient received subcutaneous heparin and venodyne boots were used during this stay; was encouraged to get up and ambulate as early as possible. at the time of discharge, the patient was doing well, afebrile with stable vital signs. the patient was tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. medications on admission: asa 81 mg daily atenolol 50 mg daily nitrostat - prn; has never used nicotine patch 21 mg daily discharge medications: 1. omeprazole 20 mg po daily 2. aspirin 81 mg po daily 3. atenolol 50 mg po daily 4. nitroglycerin sl 0.3 mg sl prn chest pain 5. nicotine patch 14 mg td daily 6. cephalexin 500 mg po q6h 7. famotidine 20 mg po q12h 8. hydromorphone (dilaudid) 2-4 mg po q4h:prn pain 9. docusate sodium 100 mg po bid discharge disposition: home with service facility: discharge diagnosis: 1. ampullary adenoma 2. chronic cholecystitis and cholelithiasis 3. etoh withdrawal discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the surgery service at for surgical resection of your pancreatic mass. you have done well in the post operative period and are now safe to return home to complete your recovery with the following instructions: please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. avoid driving or operating heavy machinery while taking pain medications. please follow-up with your surgeon and primary care provider (pcp) as advised. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *right lateral part of you wound is open and will be packed with gauze. *please call dr. office if you notice fever > 101, your incision become more red or swollen, output will increase or become odorous. followup instructions: department: surgical specialties when: monday at 11:45 am with: , md building: campus: east best parking: garage . please follow up with dr. (pcp) in weeks after discharge. . please follow up with your cardiologist in weeks after discharge. procedure: cholecystectomy excision of ampulla of vater (with reimplantation of common duct) exploration of common duct removal of pancreatic tube or drain diagnoses: other primary cardiomyopathies acidosis coronary atherosclerosis of native coronary artery tobacco use disorder unspecified essential hypertension chronic airway obstruction, not elsewhere classified other and unspecified hyperlipidemia loss of weight calculus of gallbladder with other cholecystitis, without mention of obstruction chronic pancreatitis obstruction of bile duct other and unspecified alcohol dependence, continuous other alteration of consciousness alcohol withdrawal benign neoplasm of liver and biliary passages 

Answer: The patient is high likely exposed to