In the 1990s, Midway learned from Pit Fighter - resolution constraints meant that the game looked like crap. As a result Mortal Kombat had smaller sprites, and didn't go for detail. When the sky darkened and an ominous voice said "Finish Him!" the animation of a ninja pulling a head off, the rest of the spinal column following, was cartoonish. So most people saw the ESRB's concern like anti-Elvis hysteria.
The graphics got better. A lot better.
The video game industry never learned from movies - it's good to have someone telling you when you've gone too far. People dislike a Mary Whitehouse but at the same time, few people watch Irreversible's too long and harrowing rape scene, or its worse and overlong and graphic scene where a man methodically pulps someone's face in with an extinguisher, eventually having him futilely smashing at a mass of ruined bone. Few people can stomach grotesque violence. I mean, it's a commentary of sorts that the director is an extra as a man masturbating to the violence.
Now Mortal Kombat's decided seeing someone pulp someone else isn't enough. Now in X-Ray!. Some fatalities actually exceed the movie violence involving an actual horror character.
Pulling someone screaming through a buzzsaw bisecting them from the crotch up? Pass.
It's actually affected sales. Some gamers decided that violence and torture weren't entertainment, irony being these were those who rolled their eyes at parents telling them to turn Mortal Kombat off. In essence, the ESRB was right. Unfortunately it took changes in resolution and detail to demonstrate this.
BrevityQuest 2005 - 286 words