Laugh so hard milk would come out your nose if you were drinking any at the time.
Alicia from Meffid

Glossary: 

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If you laugh so hard that liquid shoots out your nose, the verb is "snarf"; for example, "When she told the joke, I snarfed."

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When I lived down south, I heard the expression "fell out" a lot. Usually along the lines of, "It was so funny, I 'bout fell out." or "... I like to fell out."

So I don't know if this expression originated here, but it's not exclusively used here.

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