TNF and Crohn disease: Subsequently, treatment was transitioned to the Janus kinase (JAK) inhibitor upadacitinib, which led to full symptom resolution and mucosal healing on follow-up endoscopy.<h4>Conclusion</h4>This case underscores the diagnostic and therapeutic challenges associated with intestinal BD, especially in distinguishing it from Crohn's disease and addressing resistance to anti-TNF agents.