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And the characteristic of the item is to have a 50% chance of placing an internal bomb on all the enemies in the room (increasing their speed slightly) or instead replacing Isaac's head with a bomb.
If Isaac has a bomb head, he increases his speed to maximum and when he hits an enemy he will do x3 the damage of his bombs and stun the target.
As an extra detail, if Isaac dies with the bombinomicon, an HD explosion will play over him
(if you get it your a real one)