Appendicitis is usually caused by blockage of the lumen of the appendix. Obstruction causes the mucus produced by mucous appendix suffered dam. The longer the mucus is more and more, but the elastic wall of the appendix has limitations that lead to increased intra-luminal pressure. These pressures will impede the flow of lymph resulting in mucosal edema and ulceration. At that time there was marked focal acute appendicitis with epigastric pain.