 The American region 0 version (aka "The Grim Reaper") replaces the original  music with the soundtrack used in _Kingdom of the Spiders (1977)_ (qv). In  addition to that, two scenes of extreme gore were cut; the first is where the  maniac pulls out and eats a womans unborn baby. The other is the final scene  which after the maniac is stabbed by a pickaxe in the abdomen, he pulls out  and starts to eat his own entrails in a futile attempt to keep them inside  him which completely alters the ending of the film. This version in total  appears to be around 10 mins shorter than the full 91 minute Italian version,  though some of the edits are also dialogue scenes. The U.S Special Edition on  the Media Blasters/Shriek Show label is the original version and fully uncut.