But as civilians tried to flee on Wednesday, dozens were killed and injured in an artillery attack by the Assad regime, according to local rescue workers known as the White Helmets.

The emergency responders posted footage of what they said was the aftermath. The images are graphic and many may find them distressing.

Also on Wednesday, Syrian state media reported deadly rebel shelling in the government-controlled west of the city.

45 killed & 50+ injured after regime targeted civilians fleeing west on foot within besieged #Aleppo with artilleryhttps://t.co/ZN7Z6L7Pn2 pic.twitter.com/7FGfCbx7sT

— The White Helmets (@SyriaCivilDef) 30 novembre 2016

For President Assad’s chief ally Russia, the Syrian army advance is a liberation for trapped civilians.

Russian Foreign Ministry Spokeswoman Maria Zakharova said:

“More than 8,500 civilians, including about 4,000 children, escaped from the districts which had been controlled by armed groups including Jabhat Fateh al-Sham (formerly known as the Nusra Front) during the demoralised militants’ chaotic retreat.”

As Russia said it would provide safe passage for aid supplies into eastern Aleppo, the Syrian military denied claims by the British-based monitor the Syrian Observatory for Human Rights that the regime was detaining some of the thousands of people fleeing.

A Syrian military source said only that checks are being made to weed out militants.

Food is becoming increasingly scarce.

Up to 100,000 children are unable to escape the destruction in East #Aleppo as attacks close in: https://t.co/w2HdcgsTJz #Syria pic.twitter.com/fGswNejrbo

— Save the Children (@save_children) 29 novembre 2016

“We are, of course, extremely concerned about the situation of especially little kids because they are much more vulnerable than adults…and can be weakened much faster,” World Food Programme Spokeswoman Bettina Luescher said on Tuesday.

Up to 100,000 youngsters are unable to escape the destruction, according to the Save the Children charity, in a place widely described as Hell on Earth. (Euronews)