What can cause excessive internal bleeding without any external bleeding?

A peptic ulcer is a type of sore that develops on the lining of the stomach, small intestine, or esophagus due to the action of stomach acid. When a peptic ulcer erodes deeper into the tissue, it can damage blood vessels, leading to internal bleeding. The bleeding occurs internally without necessarily presenting with visible external signs, especially if the ulcer is located in the stomach or duodenum. This can result in symptoms such as weakness, pallor, and abdominal pain or discomfort, but it may be difficult to ascertain the cause without appropriate medical evaluation.

In contrast, while gastric ulcers also lead to internal bleeding, when referring to the broader category, peptic ulcers include both gastric and duodenal ulcers, thereby making them the answer in this context as they demonstrate the mechanism of internal bleeding due to ulcer formation specifically.

Diverticulitis, though it can cause rectal bleeding and abdominal pain, typically involves localized infection and inflammation that may lead to external bleeding in some cases. Gallbladder disease mainly causes abdominal pain and digestive issues, but it does not primarily result in internal bleeding without external bleeding.