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Researchers are evaluating Damage Control Surgery (DCS) as a treatment option for patients with severe acute diverticulitis classified as Hinchey III or IV, which involves purulent or fecal peritonitis. This condition usually requires emergency surgery due to bowel perforation. The trial aims to analyze whether DCS, involving bowel resection, leaving the abdomen open, and delayed bowel reconnection, may offer benefits compared to traditional approaches like the Hartmann procedure, which is associated with high rates of complications and stoma permanence. The study seeks to better understand the rationale and outcomes of DCS in these critically ill patients. The main intervention being studied is Damage Control Surgery, which includes simple bowel resection, leaving the abdomen open, and delayed anastomosis performed in cases of Hinchey III or IV diverticulitis. This approach is being assessed internationally to see if it reduces the need for Hartmann procedures and improves patient outcomes. The study does not specify additional treatment groups but focuses on the outcome of this surgical technique. Participants will be patients over 18 years old who have undergone surgery for Hinchey III or IV diverticulitis using the DCS approach. Researchers will monitor mortality, morbidity, and total morbidity over a 60-day period following surgery. The study will assess how well patients recover and the safety of the DCS technique. Participants' health status and surgical outcomes will be closely tracked during this timeframe to determine the potential benefits or risks of this treatment.