More than 300 people have been injured and scores more are feared to have been killed by artillery shells fired into a region of Sri Lankan designated a "safe zone" by the government.

Fears were growing today for hundreds of ethnic Tamil civilians trapped by fighting between the government and Tamil Tiger rebels. Some sources today claimed up to 300 people had been killed, but there was no way of confirming casualty claims from either side in the conflict zone as independent journalists have been barred.

A health official said it remained difficult to obtain a full account of the death toll in the 13.5 square mile area in northern Sri Lanka. Dr Satyamurthy, the most senior government health official in the district, said 27 civilians had been killed and 76 wounded when 1,000 shells fell on a hospital complex. It was not known who fired the shells.

Military spokesman Brigadier Udaya Nanayakkara denied that civilians had been targeted in the fighting.

Fighting between government troops and the separatist Tamils has intensified. Sri Lanka's army has pushed the rebels from their strongholds, and Mullaitivu, their last major base in the north-east, fell on Sunday.

The Liberation Tigers of Tamil Eelam no longer control any major town and are confined to a handful of jungle bases and villages. That raises questions as to whether the rebels' days as a conventional fighting force are over.

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