。
She answered angrily, as if spitting the words out.
Literal
She [topic-は] got-angry [and-て] spit-out [as if-ように] answered.
吐き出すように ('as if spitting out') is a vivid simile using ~ように to compare the manner of speech to the physical act of spitting. 吐き出す is a compound verb (吐く 'to spit/exhale' + 出す 'to put out'). The image is of words being expelled with force and contempt rather than spoken normally.