The main cause of acute suppurative appendicitis is due to appendiceal obstruction. The appendix is a distal closed intestinal canal, and most often the appendix is obstructed due to fecal stones or food debris, which then leads to poor blood supply to the distal end, which itself is prone to intestinal bacterial growth leading to septic infection if the infection is not controlled in time. In severe cases, perforation or even peritonitis may occur. Other causes are bloodstream infections, where bacteria from other sites spread bloodstream after infection, but such infections are relatively rare.