SANTO DOMINGO (AFP) - At least 18 people, including four Italian tourists, were killed in a crash involving two buses and a pick-up truck in the Dominican Republic, Dominican and Italian officials said. "We recovered 18 bodies from the scene of the accident," and at least 20 people were injured, said Lucas Evangelista Perez Jose, an official in Higuey town near the accident, where a makeshift morgue was set up. "We sent six seriously wounded people by helicopter to Santo Domingo. I don't know if any of them died," he said on Friday. The Italian Foreign Ministry said four Italian tourists died Friday, from a group of 23 travelling in one of the buses. Emergency services coordinator Juan Manuel Mendez Garcia said an earlier toll of 23 dead was wrong due to a counting error. The mutilated state of the bodies made counting difficult, he said, adding that the Dominican government was expected to give an official toll. The Italian Foreign Ministry also said 15 Italians were injured, three of them seriously, in the crash near the La Romana resort area in the province of La Altagracia, 150 kilometers (93 miles) east of the capital. The accident occurred Friday morning, at a time of the year when hotels in the area are filled with international travelers. A tourist bus and a passenger bus collided head on when one attempted to pass a pick-up truck in a steep area with poor visibility, Civil Defense authorities said. Witnesses described horrifying scenes of mutilated bodies and body parts scattered near the collision site. Due to the impact of the crash, the doors of the buses were jammed shut, and dazed and wounded passengers waited hours to be rescued. One of the buses, carrying more than 40 tourists to renowned Bavaro beach, flipped and lay across the road with its wheels in the air, the majority of its passengers trapped inside until rescuers arrived.