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It's generally recommended to check the miniboss rooms first, because they're faster, but otherwise it's just luck.
Without mods, absolutely.
You need to have cleared at least 7 chambers in Styx for it to spawn, and each wing can only be a maximum of 5 chambers long.
Additionally, the RNG is skewed so that the sack spawning is more likely than unlikely (I've seen claims of anywhere from 54-61%), so if it were possible for it to spawn in the first wing, that would be the most common outcome.