Japan has always been weirdly finnicky when it came to video games and bloody gore despite their anime, movies, and shows having gory stuff. Several games made in Japan were released internationally uncensored, like Resident Evil and Ninja Gaiden, but had to be censored in their own country.

Inversely, lots of Japanese anime games have a lot of sexual content and big titty fanservice, like Senran Kagura, and that sometimes leads to those games being censored or unreleased in English speaking countries. I guess it's just cultural differences for ya'.