**Core Concept**
Esophageal atresia is a congenital anomaly where the esophagus fails to develop completely, resulting in a blind-ending pouch. This condition often presents with respiratory distress and feeding difficulties in newborns. The pathophysiology involves abnormal embryonic development of the foregut.

**Why the Correct Answer is Right**
Esophageal atresia can occur with or without a tracheoesophageal fistula, which is an abnormal connection between the esophagus and the trachea. The most common type is the distal tracheoesophageal fistula, where there is a fistulous connection between the distal esophagus and the trachea. This can lead to aspiration of food and saliva into the lungs, causing respiratory complications. The VACTERL association, which includes vertebral, anal, cardiac, tracheoesophageal, renal, and limb abnormalities, is also associated with esophageal atresia.

**Why Each Wrong Option is Incorrect**
**Option A:** Esophageal atresia is often associated with polyhydramnios, a condition characterized by an excess of amniotic fluid. This is correct, so we will skip it.

**Option B:** Esophageal atresia is often diagnosed prenatally using ultrasound or MRI. This is also true, so we will skip it.

**Option C:** Esophageal atresia is often treated with a gastrostomy tube for feeding. This is not true, as the primary treatment for esophageal atresia is surgical repair, usually via a thoracotomy or thoracoscopic approach, to restore the continuity of the esophagus.

**Option D:** Esophageal atresia can occur with or without a tracheoesophageal fistula. This is correct, so we will skip it.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that esophageal atresia often presents with a history of regurgitation or coughing after feeding, and may be associated with other congenital anomalies. A high index of suspicion is necessary for early diagnosis and treatment.

**Correct Answer: C. Esophageal atresia is often treated with a gastrostomy tube for feeding.**