本文报道4例伴严重肠道症状的中毒性表皮坏死松解症(TEN)。男1例,女3例,平均年龄42岁(34～55岁)。4例均无肠病史。3例发病原因与药物明显有关。平均受累体表面积为37%。4例均有腹痛及大量血性腹泻,2例尚有呕血。3例消化道症状与皮损同时发生,粪便检查阳性,但用抗生素及肠道灭菌治疗不能改变肠病的病程。2例有呕血者作上胃肠道内窥镜检查示十二指肠弥漫性渗血性损害,粘膜明显肿胀、脆、呈红斑样。例4有弥漫性坏死性食道炎。4例结肠镜检查均示弥漫性表浅性粘膜损害,表现为充血、脆及糜烂,损害主要累及直肠及乙状结肠。例1亦有回肠受累,并且整个小肠 We report four cases of toxic epidermal necrolysis (TEN) with severe intestinal symptoms. 1 males and 3 females, the average age of 42 years (34 to 55 years old). All 4 patients had no history of enteropathy. The causes of 3 cases were obviously related to the drug. The average affected body surface area was 37%. 4 cases had abdominal pain and a large number of bloody diarrhea, 2 cases still vomiting blood. 3 cases of gastrointestinal symptoms and skin lesions occur simultaneously, stool examination was positive, but with antibiotics and intestinal sterilization can not change the course of intestinal disease. 2 cases of hematemesis for gastrointestinal endoscopy showed duodenal diffuse hemorrhagic damage, mucosal obvious swelling, crisp, erythema-like. Example 4 diffuse necrotic esophagitis. 4 cases of colonoscopy showed diffuse superficial mucosal damage, manifested as congestion, brittle and erosion, damage mainly involving the rectum and sigmoid colon. Example 1 also involved the ileum, and the entire small intestine