Passive congestion of the spleen occurs with cardiac decompensation. The spleen is enlarged and firm because of the retention of blood in the pulp sinusoids.In Banti's syndrome more severe congestive splenomegaly occurs with portal hypertension. The retained blood dilates the sinusoids and thickens their walls. Increased blood destruction leads to anemia and leukopenia. The condition may result from hepatic cirrhosis or from pressure on or thrombosis in the portal or splenic veins. These are associated with gastric hemorrhages. In such cases anemia is relieved by splenectomy, but the gastrointestinal hemorrhages may recur.
