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Maybe he was trying to lift his truck for some reason and got a hernia as a result? The "sexual way" could refer to his privates, and that would likely be the area that he could have blown out if he was straining enough.
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"Yes, I rather like this God fellow. He's very theatrical, you know, a pestilence here, a plague there. Omnipotence. Gotta get me some of that." -Stewie
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