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May 18, 1963

Progress in Gastroenterology

JAMA. 1963;184(7):601. doi:10.1001/jama.1963.03700200123029

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To the Editor:  —While browsing through a back issue of The Journal, I encountered this query by a Texas physician: "Is there any possibility that the development of a duodenal ulcer could be caused or contributed to by previous biliary tract disease, or biliary tract surgery?" (JAMA168:2080 [Dec 13] 1958).I wrote to the doctor, suggesting that if his case fitted the criteria necessary to permit a diagnosis of duodenal ulcer resulting from biliary tract disease, I should be much interested in receiving a report of the details.In his reply, the doctor said that he posed his question because an insurance company had refused to pay a claim for treatment of duodenal ulcer to a patient whose policy contained a waiver excluding biliary tract disease, "because the company regarded the duodenum as an integral part of the biliary system." A letter to him signed by the vice-president

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